Clinical Effect Of Minimally Invasive Treatment Of Schatzker Ⅴ And Ⅵ Type Tibial Plateau Fractures Assisted By Orthopedic Traction Bed

Objective:By comparing indirect reduction of orthopedic traction bed combined with minimally invasive internal fixation with the traditional open reduction and internal fixation to treat Schatzker Ⅴ,Ⅵ tibial plateau fractures of the indicators,including intraoperative reference index and postoperative reference index.To analyze and clarify the differences and advantages and disadvantages between the two.Further pointing out the advantages and disadvantages of minimally invasive treatment.For Schatzker V,VI patients with tibial plateau fractures to provide a reliable treatment.Method:A total of 60 patients with fracture were included in the experiment,which were divided into two groups,30 in the research group and 30 in the control group,all of whom received informed consent.All patients were from the department of orthopaedics and traumatology of changshu hospital of traditional Chinese medicine affiliated to nanjing university of traditional Chinese medicine and the department of orthopaedics and traumatology of suzhou hospital of traditional Chinese medicine from October 2016 to October 2018.The study group was treated with indirect reduction and minimally invasive plate fixation in orthopedic traction bed.In the control group,the traditional surgical method,namely open reduction and internal fixation,was used.The two groups of surgeons were the same people.The patients were followed up for 5 months after the operation,and the positive and lateral knee x-rays were taken regularly.The healing of the broken end was evaluated according to each knee X-ray.At the last follow-up,patients’osteoarthritis index(WOMAC)score and HSS score were recorded.At the end of the treatment,the operation time,intraoperative bleeding,the length of the incision and the incidence of postoperative complications were counted.Finally,SPSS22.0 software was used to calculate and compare the two groups of statistical data to obtain the data and draw a table to record the final results.Result:①There was no significant difference in the general original data between the two groups before the operation(P>0.05).②Operation time:The operation time of the study group and the control group was 70.90±4.51 min and 和 79.70±4.65min,respectively.The study group was superior to the control group,and the difference was statistically significant(P<0.05),③Intraoperative bleeding:The intraoperative bleeding in the study group and the control group was 123.67±44.29ml and 163.00±43.24ml,respectively.The intraoperative bleeding in the study group was significantly reduced,and the difference was statistically significant(P<0.05).④Operative incision length:The operative incision length of the study group and the control group was 16.15±1.93cm and 17.46±1.82cm,respectively.The operative incision length of the study group was relatively short,and the difference was statistically significant(P<0.05).⑤At the last follow-up,the patients’osteoarthritis index(WOMAC)score was 27.13±4.34 and 66.57±9.85,respectively,in the study group and the control group.The study group had significant advantages,and the difference was statistically significant(P<0.05).⑥At the last follow-up,the HSS score of the patients in the us New York hospital for special surgery(HSS)was 90.00%in the study group and 73.33%in the control group,and the difference was statistically significant(P<0.05).⑦The incidence of postoperative complications:the incidence of postoperative complications in the study group and the control group was 3.33%and 16.67%,respectively.The study group was significantly better than the control group,and the difference was statistically significant(P<0.05).Conclusion:Indirect reduction of orthopedic traction bed combined with minimally invasive internal fixation therapy Schatzker V,VI tibial plateau fractures has a certain advantage.The clinical efficacy of indirect reduction of orthopedic traction bed with minimally invasive plate internal fixation and conventional open reduction and internal fixation for SchatzkerV and type VI tibial plateau fractures was statistically significant.To conform to the mining of minimally invasive surgical treatment of traction bed Schatzker V,VI tibial plateau fractures,patients with intraoperative situation(operation time,intraoperative bleeding and incision length)compared with the traditional surgery group has obvious advantages.The WOMAC score and HSS score at the last follow-up were statistically significant between the two groups.The incidence of postoperative complications in the study group was significantly lower than that in the control group.The main disadvantages of the study group were too many inclusion criteria,incomplete observation of posterior column fractures during surgery,and disadvantages in the treatment of tibial plateau fractures with posterior column fractures.The disadvantages of the control group were more postoperative complications,longer incision and more intraoperative bleeding.Therefore,the use of traction bed minimally invasive surgery for Schatzker V and Type VI tibial plateau fractures meeting the inclusion criteria can achieve satisfactory clinical results.In addition,it has the advantages of low incidence of postoperative complications,small impact on joint function,simple operation and so on,which is worthy of extensive promotion in clinical practice.