Franulic N, Brito C, Del Pino C, Laso J, Rojas C, Olivieri R, Gaggero N
Traumatología Equipo Rodilla, Hospital del Trabajador ACHS, Santiago, Chile; Traumatología Equipo Rodilla, Hospital Militar de Santiago, Santiago, Chile.
Traumatología General, Universidad de los Andes, Santiago, Chile.
Rev Esp Cir Ortop Traumatol. 2023 Jul-Aug;67(4):T290-T296. doi: 10.1016/j.recot.2023.01.006. Epub 2023 Mar 20.
The use of arthroscopy for tibial plateau fractures type I, II and III according to Schatzker classification has increased, yet its employment for tibial plateau fractures Schatzker IV, V and VI is controversial due to the potential risk of compartment syndrome, deep vein thrombosis and infection. We aimed to compare the rate of operative and postoperative complications among patients with these types of tibial plateau fractures treated with and without arthroscopy at the time of definitive reduction and osteosynthesis.
Retrospective cohort study. Patients with diagnosis of tibial plateau fracture Schatzker IV, V or VI who underwent reduction and definitive osteosynthesis with or without the use of arthroscopy were included. The development of compartment syndrome, deep vein thrombosis, and fracture-related infection was evaluated up to 12 months after the definitive surgery.
Two hundred eighty-eight patients were included: 86 with arthroscopic assistance and 202 without it. The overall complication rate in the group with and without arthroscopic assistance was 18.60% and 26.73%, respectively (p=.141). No statistical association was found between the use of arthroscopic assistance and the development of the analysed complications.
The use of arthroscopy to support reduction or addressing concomitant intra-articular injuries did not increase the risk of complications in patients with high-energy tibial plateau fractures at 12 months of follow up.
根据Schatzker分类法,关节镜在I型、II型和III型胫骨平台骨折中的应用有所增加,但由于存在骨筋膜室综合征、深静脉血栓形成和感染的潜在风险,其在Schatzker IV型、V型和VI型胫骨平台骨折中的应用存在争议。我们旨在比较在进行确定性复位和内固定时,接受和未接受关节镜治疗的这些类型胫骨平台骨折患者的手术及术后并发症发生率。
回顾性队列研究。纳入诊断为Schatzker IV型、V型或VI型胫骨平台骨折且接受了复位及确定性内固定(无论是否使用关节镜)的患者。在确定性手术后长达12个月的时间内评估骨筋膜室综合征、深静脉血栓形成和骨折相关感染的发生情况。
共纳入288例患者:86例接受关节镜辅助,202例未接受关节镜辅助。关节镜辅助组和非关节镜辅助组的总体并发症发生率分别为18.60%和26.73%(p = 0.141)。未发现关节镜辅助的使用与所分析并发症的发生之间存在统计学关联。
在随访12个月时,使用关节镜辅助复位或处理合并的关节内损伤并未增加高能胫骨平台骨折患者的并发症风险。