Biswas Bhaskar, Halam Ajoy K, Chowdhury Arpita, Purkayastha Tuhin, Reang Santosh
Orthopedics, Agartala Government Medical College and Govind Ballabh Pant (GBP) Hospital, Agartala, IND.
Orthopedics, Dhalai District Hospital, Dhalai, IND.
Cureus. 2024 May 11;16(5):e60078. doi: 10.7759/cureus.60078. eCollection 2024 May.
Tibial plateau fractures pose a significant challenge to orthopedic surgeons due to their complex nature and potential for long-term morbidity. Surgical intervention is often necessary to restore anatomical alignment and optimize functional outcomes. This study aimed to evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) compared to open reduction and internal fixation (ORIF) in the management of tibial plateau fractures.
The present hospital-based observational study was conducted at Agartala Government Medical College for two years. Seventy adult patients with tibial plateau fractures were included, with surgical interventions performed based on fracture characteristics. Postoperative outcomes, including knee range of movements, functional recovery, and complication rates, were assessed at six months.
MIPPO demonstrated superior outcomes compared to ORIF, with a higher proportion of participants achieving knee range of movements > 120 degrees (66.7% versus 36%; p = 0.030), excellent functional outcomes (66.7% versus 36%; p = 0.046), and lower postoperative complication rates (2.2% versus 28%; p = 0.001). Fracture union times were significantly shorter in MIPPO (12.49 weeks) when compared to ORIF (14 weeks) (p = 0.009).
MIPPO offers advantages over conventional ORIF in terms of functional recovery and complication rates while demonstrating comparable fracture union times. These findings advocate for the adoption of MIPPO as a preferred surgical technique for tibial plateau fractures.
由于胫骨平台骨折的复杂性及长期发病的可能性，给骨科医生带来了重大挑战。通常需要进行手术干预以恢复解剖对位并优化功能结果。本研究旨在评估微创经皮钢板接骨术（MIPPO）与切开复位内固定术（ORIF）在治疗胫骨平台骨折方面的疗效。
本基于医院的观察性研究在阿加尔塔拉政府医学院进行了两年。纳入了70例成年胫骨平台骨折患者，根据骨折特征进行手术干预。在术后六个月评估包括膝关节活动范围、功能恢复和并发症发生率在内的术后结果。
与ORIF相比，MIPPO显示出更好的结果，达到膝关节活动范围>120度的参与者比例更高（66.7%对36%；p = 0.030），功能结果优秀（66.7%对36%；p = 0.046），且术后并发症发生率更低（2.2%对28%；p = 0.001）。与ORIF（14周）相比，MIPPO的骨折愈合时间显著更短（12.49周）（p = 0.009）。
在功能恢复和并发症发生率方面，MIPPO优于传统的ORIF，同时骨折愈合时间相当。这些发现主张采用MIPPO作为治疗胫骨平台骨折的首选手术技术。
