AI Article Synopsis
- - The study compares the effectiveness of two surgical techniques for treating Schatzker type II and III tibial plateau fractures: arthroscopic reduction and internal fixation (ARIF) and open reduction and internal fixation (ORIF).
- - A retrospective review was conducted on 68 patients, revealing that ARIF had a shorter hospital stay and found more intra-articular injuries compared to ORIF, but both methods showed similar clinical outcomes and complication rates.
- - The results suggest that while ARIF may lead to quicker recovery, both ARIF and ORIF ultimately lead to comparable healing and functional results for this type of fracture.
Article Abstract
Background: Tibial plateau fractures require anatomical reduction and stable fixation to achieve satisfactory results. In addition, addressing any related injuries is of paramount importance. Arthroscopic reduction and internal fixation (ARIF) has been promoted as a possible technique to treat tibial plateau fractures.
Purpose: To compare the effectiveness of ARIF with this modified reducer and open reduction and internal fixation (ORIF) for Schatzker types II and III tibial plateau fractures.
Study Design: Cohort study; Level of evidence, 3.
Methods: We retrospectively reviewed 68 patients who were treated for Schatzker type II or III tibial plateau fractures between August 1, 2014, and October 31, 2018. Patients were categorized into the ARIF (n = 33) and ORIF groups (n = 35). The groups were compared regarding intra-articular injuries, duration of hospital stay, complications, and clinical outcomes-including the International Knee Documentation Committee (IKDC) score, the Hospital for Special Surgery (HSS) score, and range of motion (ROM). The paired test was used to compare preoperative and postoperative data, and the chi-square test was used to compare the IKDC and HSS scores.
Results: The median follow-up period was 36 months (26-40 months). Additional intra-articular lesions were found in 29 patients-21 in the ARIF group and 8 in the ORIF group ( = .02). A significant difference was observed in the duration of hospital stay-3.58 ± 1.46 days for the ARIF group and 4.57 ± 1.12 days for the ORIF group ( = -3.169; = .002). All fractures healed within 3 months after surgery. The complication rate for all patients was 11%, with no significant difference between the ARIF and ORIF groups ( = 1.244; = .265). At the final follow-up, there were no significant differences between the 2 groups in the IKDC score, HSS score, and ROM ( > .05 for all).
Conclusion: ARIF with a modified reducer was found to be an effective, reliable, and safe procedure for the treatment of Schatzker types II and III tibial plateau fractures. Both ARIF and ORIF provided equally good results, while ARIF offered a more precise evaluation and reduced the duration of hospital stay.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10291418 | PMC |
| http://dx.doi.org/10.1177/23259671221151159 | DOI Listing |
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