Li Guimiao, Zhang D, He Wei, Wang Zhongzheng, Yang Yanjiang, Fu Chunxu, Cheng Xinqiun, Xing Xin, Feng Chen, Chen Wei, Zhang Yingze
Trauma Emergency Center, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Orthopaedic Research Institute of Hebei Province, Shijiazhuang, China.
Int Orthop. 2025 Jun;49(6):1529-1536. doi: 10.1007/s00264-025-06471-x. Epub 2025 Apr 26.
This study aimed to evaluate long-term radiological and functional outcomes in tibia plateau fractures (TPFs) patients treated using minimally invasive percutaneous plate osteosynthesis (MIPPO) and Double Reverse Traction Repositor (DRTR).
We reviewed 85 patients treated with MIPPO and DRTR at our hospital from January 2015 to December 2017. Radiologic outcomes, including tibial plateau angle (TPA), posterior slope angle (PSA), and Kellgren-Lawrence classification, were assessed, while functional outcomes were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form (SF)-36, and Hospital for Special Surgery Knee Score (HSS score). Data from medium follow-up (4.39 ± 0.58 years) and final follow-up (7.75 ± 0.53 years) were analyzed with the Wilcoxon signed-rank test.
We included 65 patients with three(4.62%), 26(40.00%), eight(12.31%), six(9.23%), 11(16.92%), and 11(16.92%) were Schatzker I- VI, respectively. The mean follow-up time was 7.75 ± 0.53 years, with surgery performed in 5.72 ± 2.37 days post-injury and mean operation time of 96.72 ± 31.15 min. Short-term complications included two superficial infections (3.08%). Significant improvements in functional outcomes were observed at final follow-up: range of motion was 138.38° ± 8.49°, enhancements in WOMAC scores, HSS knee scores, and SF-36 (P < 0.05). No further progression of osteoarthritis was observed (K-L classification) during seven-year follow-up (P = 0.655).
MIPPO with DRTR is a promising and safe technique for the TPFs, leading to satisfactory outcomes up to seven years postoperatively, especially in reducing the incidence for knee osteoarthritis.
本研究旨在评估采用微创经皮钢板接骨术（MIPPO）和双反向牵引复位器（DRTR）治疗的胫骨平台骨折（TPF）患者的长期放射学和功能结局。
我们回顾了2015年1月至2017年12月在我院接受MIPPO和DRTR治疗的85例患者。评估了放射学结局，包括胫骨平台角（TPA）、后倾角（PSA）和Kellgren-Lawrence分级，同时使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、简明健康状况调查量表（SF-36）和特种外科医院膝关节评分（HSS评分）评估功能结局。采用Wilcoxon符号秩检验分析中期随访（4.39±0.58年）和最终随访（7.75±0.53年）的数据。
我们纳入了65例患者，其中Schatzker I - VI型分别有3例（4.62%）、26例（40.00%）、8例（12.31%）、6例（9.23%）、11例（16.92%）和11例（16.92%）。平均随访时间为7.75±0.53年，受伤后5.72±2.37天进行手术，平均手术时间为96.72±31.15分钟。短期并发症包括2例表浅感染（3.08%）。在最终随访时观察到功能结局有显著改善：活动范围为138.38°±8.49°，WOMAC评分、HSS膝关节评分和SF-36均有所提高（P<0.05）。在七年随访期间未观察到骨关节炎的进一步进展（K-L分级）（P = 0.655）。
MIPPO联合DRTR是一种治疗TPF有前景且安全的技术，术后七年可获得满意的结局，尤其是在降低膝关节骨关节炎的发生率方面。
