Li Xu-Song, Wu Jun-Le, Ye Lin, Huang Li-Ben, Huang Jie-Feng
Department of Orthopaedics & Traumatology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, Guangdong, 528400, China.
Grade 2022 Graduate, Department of Orthopaedics & Traumatology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, Guangdong, 528400, China.
BMC Musculoskelet Disord. 2024 Dec 26;25(1):1064. doi: 10.1186/s12891-024-08230-2.
This study evaluated the clinical effects of the use of a temporary bi-frame fixator in conjunction with minimally invasive percutaneous plate osteosynthesis (MIPPO) for treating AO/OTA 41B3 and 41C tibial plateau fractures (TPFs).
This was a retrospective analysis of 30 patients with TPFs affected by vertical compression seen from October 2019 to October 2020. All patients were treated with a bi-frame fixator to correct the vertical shortening deformity, with the MIPPO technique used after reduction. All patients underwent routine examinations at 1, 3, 6, 12 and 24months postoperatively and then annually. Clinical parameters assessed included the Hospital for Special Surgery score (HSS), number of assistants, intraoperative hemorrhage, intraoperative fluoroscopy frequency, length of hospital stay, and time to fracture healing. Radiographic findings were assessed using Rasmussen scores.
All patients had satisfactory fracture reduction on postoperative imaging. The average operating time was 112.03 ± 20.9 min, with 15.79 ± 3.45 fluoroscopic exposures; the average blood loss was 66.63 ± 10.88 mL, the average length of hospital stay was 12.86 ± 5.11 days, and the average fracture healing time was 10.33 ± 1.48 weeks. The mean follow-up time was 23.18 ± 2.59 months. At the last follow-up, the Rasmussen anatomical score was excellent in 22 (75.3%) patients, good in 5 (16.7%), and fair in 3 (10%). The average HSS was 65.7 ± 3.26, 82.26 ± 2.28, and 87.66 ± 2.4 after 1, 6, and 12 months, respectively, and it was 92.56 ± 2.96 at the last follow-up (F = 1073.073, P < 0.001). No complications occurred in any patient during follow-up.
For AO/OTA 41B3 and 41C fractures of the tibial plateau, the use of a temporary bi-frame fixator combined with the MIPPO technique can correct the compressed displacement, reduce soft tissue damage, and facilitate surgical reduction, which aid the recovery of joint function.
本研究评估了使用临时双框架固定器结合微创经皮钢板接骨术（MIPPO）治疗AO/OTA 41B3和41C型胫骨平台骨折（TPF）的临床效果。
这是一项对2019年10月至2020年10月间30例垂直压缩型TPF患者的回顾性分析。所有患者均采用双框架固定器纠正垂直缩短畸形，复位后采用MIPPO技术。所有患者在术后1、3、6、12和24个月以及之后每年进行常规检查。评估的临床参数包括特种外科医院评分（HSS）、助手数量、术中出血量、术中透视次数、住院时间和骨折愈合时间。使用Rasmussen评分评估影像学结果。
所有患者术后影像学检查显示骨折复位满意。平均手术时间为112.03±20.9分钟，透视曝光15.79±3.45次；平均失血量为66.63±10.88毫升，平均住院时间为12.86±5.11天，平均骨折愈合时间为10.33±1.48周。平均随访时间为23.18±2.59个月。在最后一次随访时，Rasmussen解剖学评分22例（75.3%）为优，5例（16.7%）为良，3例（10%）为可。术后1、6和12个月时HSS平均分别为65.7±3.26、82.26±2.28和87.66±2.4，最后一次随访时为92.56±2.96（F = 1073.073，P < 0.001）。随访期间所有患者均未发生并发症。
对于AO/OTA 41B3和41C型胫骨平台骨折，使用临时双框架固定器结合MIPPO技术可纠正压缩移位，减少软组织损伤，便于手术复位，有助于关节功能恢复。
