Arthroscopic-assisted open reduction and internal fixation of Schatzker type Ⅰ-Ⅲ tibial plat-eau fractures

Zhou Yin; Cao Liu; Zhou Feng; Liu Bin; Li Na

doi:10.3969/j.issn.1009-4237.2025.04.006

Abstract：Objective To assess the effect of arthroscopic-assisted open reduction and internal fixation for Schatzker type Ⅰ-Ⅲ tibial plateau fractures(TPF).Methods A total of 86 patients with confirmed Schatzker type Ⅰ-Ⅲ TPF treated in our hospital from Jan.2021 to Dec.2023 were prospectively selected and divided into an observation group(n=43)and a control group(n=43)according to the random number table method.In the ob-servation group,there were 32 males and 11 females,aged 23 to 48 years,with an average of 29.6 years.The injury mechanism was as follows:26 cases of road traffic injuries,15 falls,and 2 others.In the control group,there were 34 males and 9 females,aged 23 to 47 years,with an average of 29.8 years.The injury mechanism was as follows:27 cases of road traffic injuries,14 falls,and 2 others.The control group underwent open reduction and internal fixa-tion,while the observation group underwent arthroscopic-assisted open reduction and internal fixation.The surgery-related indicators,knee range of motion(ROM)and knee function immediately after surgery and 6 months postoper-atively,postoperative complications,and other clinical outcomes were observed in both groups.The factors affecting the prognosis of patients were analyzed.Results The observation group showed much shorter incision length(cm,3.22±0.34 vs.6.07±0.62),and less intraoperative blood loss(mL,59.0±6.2 vs.90.2±9.2),operation time(min,91.4±9.4 vs.104.1±12.2),off-bed activity time(d,3.7±0.4 vs.5.7±0.6),incision healing time(d,10.3±1.2 vs.14.4±1.7)and fracture healing time(85.4±8.7 vs.101.8±12.4),all revealing significant differ-ence with the control group(P＜0.05).The incidence of postoperative complications in observation and control groups showed no significant difference(2.3％vs.9.3％,P＞0.05).At 6 months postoperatively,the knee flexion ROM,extension ROM,Rasmussen score,and HSS score in both observation and control groups were much higher than those immediately after surgery,indicating significant differences(all P＜0.05),but comparison between the two groups showed no significant difference at each time point(all P＞0.05).The excellent and good rate was 86.1％and 88.3％for the observation and control groups,with an insignificant difference(P＞0.05).Conclusion Arthroscopic-assisted open reduction internal fixation for Schatzker type Ⅰ-Ⅲ TPF can reduce surgical invasion and postoperative complications,increase knee ROM,and improve knee function.The clinical outcomes are comparable with open reduction and internal fixation.