Clinical Application Of Arthroscopic Assisted Minimally Invasive Internal Fixation In Tibial Plateau Fractures

ObjectiveThrough comparing the therapeutic effect of surgery between arthroscopic assisted and the traditional methods,the clinical effect of minimally invasive treatment of tibial plateau fractures with the assistance of arthroscopy was analyzed.Methods56 patients with tibial plateau fractures were randomly divided into arthroscopy group and the traditional group in our hospital from June 2014 to June 2016.26 patients(arthroscopy group)with tibial plateau fractures were treated minimally invasive with the assistance of arthroscopic,including 15 males and 11 females with the avemge age of 45.5�9.6 years(aged from 21 to 58).Thirty patients(traditional group)with tibial plateau fractures were treated with the ORIF(open reduction and internal fixation),including 18 males and 12 females with the average age of 44.2�9.5 years(aged from 19 to 65).There were no significant differences in age,sex,type of fracture,course of disease and complications between the two groups(P>0.05).The data must be recorded,including the bleeding volume in surgery,the length of incision,the time of operation,the time of stay in hospital,the healing time of postoperative fracture,postoperative complications and functional recovery.The function of knee joint was evaluated by HSS scoring system.The fracture was evaluated according to the postoperative X-ray.ResultsAll 56 patients were followed up for a mean of 13.8 months(range,6-24 months).Following up the patients of two groups,X-ray examination showed that tibial plateau fractures were healing.The bleeding volume in surgery of the arthroscopic group was 62.3�17.5ml,and the traditional group was 112.3�25.1ml.The length of incision in the arthroscopic group was 6.4�1.2cm,and the traditional group was 12.5�2.2cm.The operation time in the arthroscopic group was 74.7�7.6min,and the traditional group was 59.5�6.9min.The number of fluoroscopy in the arthroscopic group was 9.6�1.7 times and the traditional group was 21.3�3.0 times.The hospital stay in the arthroscopic group was 7.2�1.1 days and 11.6�1.8 days in the traditional group.The time of the fracture healing was 3.5�0.6 months in the arthroscopic group and 3.6�0.7 in the traditional group.Comparing the length of the operation,the amount of bleeding,the length of incision,the time of hospitalization,the number of fluoroscopy,the arthroscopic group was superior to the traditional group,and the difference was statistically significant(P<0.01).Comparing the time of fracture healing,no statistically significant difference was found in the two groups(P>0.05).The HSS score in the arthroscopic group was significantly higher than that of the traditional group at 1 month,3 months and 6 months after operation(P<0.05).There was no joint stiffness,incision infection,skin necrosis and other complications in the two groups.ConclusionsComparing with the traditional open reduction internal fixation,arthroscopic assisted minimally invasive internal fixation in the treatment of tibial plateau fractures has much advantages,such as less injury,shorter time of hospital stay,quick functiol recovery.It should be worthwhile to promote extensively because of the perfect prospect.