3D Computer Simulation Combined with Arthroscopic-Assisted Treatment for Schatzker Ⅱ～Ⅲ Tibial Plateau Fractures

Wang Xiaolong; Yan Xueqin; Wang Pan; Duan Feng; Shi He; Xu Zhenzhen; Ma Jianlin; Wang Sizhe

Abstract：Objective To compare the clinical efficacy of 3D modeling simulation combined with arthroscopic-assisted treatment and traditional open reduction and internal fixation(ORIF)for Schatzker type Ⅱ to Ⅲ tibial plateau fractures.Methods A retrospective analysis was conducted on 60 patients with Schatzker type Ⅱ to Ⅲ tibial plateau fractures treated at The People's Hospital of Chengyang District from January 2018 to December 2021.Thirty patients treated with 3D modeling simulation combined with arthroscopic assistance were assigned to the observation group,and 30 patients treated with traditional ORIF were assigned to the control group.The observation group included 17 males and 13 females,with a mean age of(47.30±11.70)years(range,20 to 65 years).The control group included 16 males and 14 females,with a mean age of(46.37±11.80)years(range,22 to 65 years).Intraoperative indicators and complications were compared between the two groups.Surgical outcomes were evaluated using the visual analogue scale(VAS)for pain,the hospital for special surgery(HSS)knee score,the Rasmussen functional score,and the Rasmussen fracture reduction score.Results There was no significant difference in operative time between the two groups(P＞0.05).The observation group had significantly fewer intraoperative fluoroscopy times,shorter surgical incision length,less postoperative drainage volume,and shorter joint reduction time compared with the control group(P＜0.05).All patients were followed up for at least 12 months,with bony union achieved at 3 to 6 months postoperatively.At 3 days postoperatively,the VAS score in the observation group was lower than that in the control group(P＜0.05).At 1 month postoperatively,the HSS and Rasmussen scores in the observation group were significantly higher than those in the control group(P＜0.05).The excellent and good rate of the HSS score was 100％in the observation group and 66.70％in the control group at 1 month postoperatively;the control group also achieved a 100％excellent and good rate at 12 months postoperatively.The Rasmussen fracture reduction score in the observation group was higher than that in the control group immediately after surgery and at 12 months postoperatively(P＜0.05).Conclusion Compared with traditional ORIF,3D combined with arthroscopic-assisted treatment for Schatzker type Ⅱ to Ⅲ tibial plateau fractures results in fewer intraoperative fluoroscopy times,less surgical trauma,more precise and efficient fracture reduction,and better functional recovery postoperatively.