Application of fracture distal-based fragment reduction in surgery for complex tibial plateau fractures and its effect on postoperative joint function recovery
YU Jin-na
QU Wei
FAN A-ling
ZHANG Yun-peng
Abstract：Objective To explore the application of a reduction method based on the distal fragment of the frac-ture in surgeries for complex tibial plateau fractures and its effect on postoperative joint function recovery.Methods A prospective study was conducted on 114 patients with complex tibial plateau fractures treated between January 2021 and September 2023.Patients were randomly divided into two groups(n=57 each).All patients underwent open reduction and internal fixation(ORIF).The control group received conventional intraoperative reduction-first restoring the articu-lar surface,then fixing it to the distal tibial fragment.The study group underwent reduction based on the distal fracture fragment.Outcomes compared between groups included reduction quality,surgical parameters,serum levels of nerve growth factor(NGF),alkaline phosphatase(ALP),and soluble vascular cell adhesion molecule(sVCAM)before and after surgery,knee joint function[Rasmussen radiographic score and Hospital for Special Surgery(HSS)knee score],quality of life[Short Form-36(SF-36)score],and incidence of complications.Results The study group showed bet-ter reduction quality than the control group(P＜0.05).Postoperative weight-bearing time and fracture healing time were shorter in the study group(P＜0.05).At 1 week and 1 month postoperatively,serum NGF and ALP levels were higher,and sVCAM levels were lower in the study group compared to the control group(P＜0.05).Rasmussen and HSS scores at 3 and 6 months postoperatively were significantly higher in the study group(P＜0.05).At 6 months,the study group also had higher SF-36 scores in general health,vitality,physical function,social function,and mental health(P＜0.05).The complication rate was lower in the study group(P＜0.05).Conclusion In ORIF for complex tibial plateau frac-tures,employing a reduction method based on the distal fracture fragment can improve reduction quality,reduce postop-erative complications,promote fracture healing and early weight-bearing,and enhance knee function and quality of life.
Keywords：tibial plateau fracturedistal fragmentreductionalkaline phosphatasenerve growth factor
Publication Date：2025-08-15
Online Publishing Date：2025-11-06(First online date of this platform, not the publication date of the document)
Pages：7( 1235-1241 )