EFFECTIVENESS OF OPEN REDUCTION AND INTERNAL FIXATION WITHOUT OPENING JOINT CAPSULE ON TIBIAL PLATEAU FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHENQi ,  XUXiaofeng , HUANGYonghui , CAOXingbing , MENGChen , CAOXueshu , WEIChangbao

No. 2 Department of Orthopedics, Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu, 212001, P. R. China;

Corresponding author：

XUXiaofeng, Email: jackiechanoth@163.com

Keywords：

Tibial plateau fracture; Open reduction; Joint capsule; Internal fixation of fracture

DOI：

10.7507/1002-1892.20140317

Video：

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Objective To introduce the surgery method to reset and fix tibial plateau fracture without opening joint capsule, and evaluate the safety and effectiveness of this method. Methods Between July 2011 and July 2013, 51 patients with tibial plateau fracture accorded with the inclusion criteria were included. All of 51 patients, 17 cases underwent open reduction and internal fixation without opening joint capsule in trial group, and 34 cases underwent traditional surgery method in control group. There was no significant difference in gender, age, cause of injury, time from injury to admission, side of injury, and types of fracture between 2 groups (P>0.05). The operation time, intraoperative blood loss, incision length, incision heal ing, and fracture healing were compared between 2 groups. The tibial-femoral angle and collapse of joint surface were measured on X-ray film. At last follow-up, joint function was evaluated with Hospital for Special Surgery (HSS) knee function scale. Results The intraoperative blood loss in trial group was significantly less than that in control group (P<0.05). The incision length in trial group was significantly shorter than that in control group (P<0.05). Difference was not significant in operation time and the rate of incision heal ing between 2 groups (P>0.05). The patients were followed up 12-30 months (mean, 20.4 months) in trial group and 12-31 months (mean, 18.2 months) in control group. X-ray films indicated that all cases in 2 groups obtained fracture heal ing; there was no significant difference in the fracture healing time between 2 groups (t=1.382, P=0.173). On X-ray films, difference was not significant in tibial-femoral angle and collapse of joint surface between 2 groups (P>0.05). HSS score of the knee in trial group was significantly higher than that of control group (t=3.161, P=0.003). Conclusion It can reduce the intraoperative blood loss and shorten the incision length to use open reduction and internal fixation without opening joint capsule for tibial plateau fracture. Traction of joint capsule is helpful in the reduction and good recovery of joint surface collapse. In addition, the surgery without opening joint capsule can avoid joint stiffness and obtain better joint function.

Citation： CHENQi, XUXiaofeng, HUANGYonghui, CAOXingbing, MENGChen, CAOXueshu, WEIChangbao. EFFECTIVENESS OF OPEN REDUCTION AND INTERNAL FIXATION WITHOUT OPENING JOINT CAPSULE ON TIBIAL PLATEAU FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(12): 1464-1468. doi: 10.7507/1002-1892.20140317 Copy

1.	Ruedi TP, Murphy WM, Moran CG. 骨折治疗的AO原则. 2版. 危杰, 刘璠, 吴新宝, 等译. 上海:上海科技出版社, 2010:58-61.
2.	李卫康, 戚浩天, 赵永杰, 等. 影响股骨髁间骨折术后膝关节功能的相关因素分析. 中国矫形外科杂志, 2013, 21(24):2443-2448.
3.	丁宏. 闭合复位及经皮空心螺钉内固定治疗胫骨平台骨折. 中国医学工程, 2012, 20(11):165, 169.
4.	Chiu CH, Cheng CY, Tsai MC, et al. Arthroscopy-assisted reduction of posteromedial tibial plateau fractures with buttress plate and cannulated screw construct. Arthroscopy, 2013, 29(8):1346-1354.
5.	Lee HJ, Jung HJ, Chang EC, et al. Second-look arthroscopy after surgical treatment of Schatzker type Ⅱ plateau fractures through the lateral submeniscal approach. Arch Orthop Trauma Surg, 2014, 134(4): 495-499.
6.	沈光银, 周建中. 关节镜辅助经皮内固定和切开复位内固定治疗Schatzker Ⅱ、Ⅲ型胫骨平台骨折的比较研究. 中国修复重建外科杂志, 2011, 25(10):1201-1204.
7.	Solomon LB, Stevenson AW, Lee YC, et al. Posterolateral and anterolateral approaches to unicondylar posterolateral tibial plateau fractures: a comparative study. Injury, 2013, 44(11):1561-1568.
8.	Berber R, Lewis CP, Copas D, et al. Postero-medial approach for complextibial plateau injuries with a postero-medial or postero-lateral shear fragment. Injury, 2014, 45(4):757-765.
9.	Johnson EE, Timon S, Osuji C. Surgical technique:Tscherne-Johnson extensile approach for tibial plateau fractures. Cl in Orthop Relat Res, 2013, 471(9):2760-2767.
10.	赵爱军, 魏学庆, 卢吉高, 等. 伴后外侧平台塌陷的SchatzkerⅤ/Ⅵ型胫骨平台骨折治疗. 中国修复重建外科杂志, 2013, 27(5):639-640.
11.	Onoda Y, Hagiwara Y, Ando A, et al. Joint haemorrhage partly accelerated immobilization-induced synovial adhesions and capsular shortening in rats. Knee Surg Sports Traumatol Arthrosc, 2013.[Epub ahead of print].
12.	Lin S, Mauffrey C, Hammerberg EM, et al. Surgical site infection after open reduction and internal fixation of tibial plateau fractures. Eur J Orthop Surg Traumatol, 2014, 24(5):797-803.
13.	徐云钦, 李强, 申屠刚, 等. 复杂胫骨平台骨折手术时机与手术方式选择及疗效分析. 中国骨与关节损伤杂志, 2013, 28(4):320-323.
14.	Tscherne H, Lobenhoffer P. Tibial plateau fractures. Management and expected results. Clin Orthop Relat Res, 1993, (292):87-100.
15.	邹华章, 马晓春, 唐程, 等. 复合型可注射磷酸钙骨水泥在胫骨平台塌陷骨折中的生物力学研究. 中国修复重建外科杂志, 2013, 27(7): 855-859.
16.	王红川, 楼华, 刘凯, 等. 改良外侧胫骨平台骨折塌陷关节面复位方法的疗效观察. 中国修复重建外科杂志, 2013, 27(1):12-16.
17.	Massé JP, Glimet T, Alpérovitch A, et al. Value of the femorotibial angle in 244 patients without knee arthrosis. Rev Rhum Mal Osteoartic, 1985, 52(2):91-94.
18.	Ghazavi MT, Paitzker KP, Davis AM, et al. Fresh osteochondral allografts for post-traumatic osteochondral defects of the knee. J Bone Joint Surg (Br), 1997, 79(6):1008-1013.
19.	Thompson JC. 奈特简明骨科学彩色图谱. 邱贵兴, 高鹏, 译. 北京: 人民卫生出版社, 2011:229.

1. Ruedi TP, Murphy WM, Moran CG. 骨折治疗的AO原则. 2版. 危杰, 刘璠, 吴新宝, 等译. 上海:上海科技出版社, 2010:58-61.
2. 李卫康, 戚浩天, 赵永杰, 等. 影响股骨髁间骨折术后膝关节功能的相关因素分析. 中国矫形外科杂志, 2013, 21(24):2443-2448.
3. 丁宏. 闭合复位及经皮空心螺钉内固定治疗胫骨平台骨折. 中国医学工程, 2012, 20(11):165, 169.
4. Chiu CH, Cheng CY, Tsai MC, et al. Arthroscopy-assisted reduction of posteromedial tibial plateau fractures with buttress plate and cannulated screw construct. Arthroscopy, 2013, 29(8):1346-1354.
5. Lee HJ, Jung HJ, Chang EC, et al. Second-look arthroscopy after surgical treatment of Schatzker type Ⅱ plateau fractures through the lateral submeniscal approach. Arch Orthop Trauma Surg, 2014, 134(4): 495-499.
6. 沈光银, 周建中. 关节镜辅助经皮内固定和切开复位内固定治疗Schatzker Ⅱ、Ⅲ型胫骨平台骨折的比较研究. 中国修复重建外科杂志, 2011, 25(10):1201-1204.
7. Solomon LB, Stevenson AW, Lee YC, et al. Posterolateral and anterolateral approaches to unicondylar posterolateral tibial plateau fractures: a comparative study. Injury, 2013, 44(11):1561-1568.
8. Berber R, Lewis CP, Copas D, et al. Postero-medial approach for complextibial plateau injuries with a postero-medial or postero-lateral shear fragment. Injury, 2014, 45(4):757-765.
9. Johnson EE, Timon S, Osuji C. Surgical technique:Tscherne-Johnson extensile approach for tibial plateau fractures. Cl in Orthop Relat Res, 2013, 471(9):2760-2767.
10. 赵爱军, 魏学庆, 卢吉高, 等. 伴后外侧平台塌陷的SchatzkerⅤ/Ⅵ型胫骨平台骨折治疗. 中国修复重建外科杂志, 2013, 27(5):639-640.
11. Onoda Y, Hagiwara Y, Ando A, et al. Joint haemorrhage partly accelerated immobilization-induced synovial adhesions and capsular shortening in rats. Knee Surg Sports Traumatol Arthrosc, 2013.[Epub ahead of print].
12. Lin S, Mauffrey C, Hammerberg EM, et al. Surgical site infection after open reduction and internal fixation of tibial plateau fractures. Eur J Orthop Surg Traumatol, 2014, 24(5):797-803.
13. 徐云钦, 李强, 申屠刚, 等. 复杂胫骨平台骨折手术时机与手术方式选择及疗效分析. 中国骨与关节损伤杂志, 2013, 28(4):320-323.
14. Tscherne H, Lobenhoffer P. Tibial plateau fractures. Management and expected results. Clin Orthop Relat Res, 1993, (292):87-100.
15. 邹华章, 马晓春, 唐程, 等. 复合型可注射磷酸钙骨水泥在胫骨平台塌陷骨折中的生物力学研究. 中国修复重建外科杂志, 2013, 27(7): 855-859.
16. 王红川, 楼华, 刘凯, 等. 改良外侧胫骨平台骨折塌陷关节面复位方法的疗效观察. 中国修复重建外科杂志, 2013, 27(1):12-16.
17. Massé JP, Glimet T, Alpérovitch A, et al. Value of the femorotibial angle in 244 patients without knee arthrosis. Rev Rhum Mal Osteoartic, 1985, 52(2):91-94.
18. Ghazavi MT, Paitzker KP, Davis AM, et al. Fresh osteochondral allografts for post-traumatic osteochondral defects of the knee. J Bone Joint Surg (Br), 1997, 79(6):1008-1013.
19. Thompson JC. 奈特简明骨科学彩色图谱. 邱贵兴, 高鹏, 译. 北京: 人民卫生出版社, 2011:229.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF OPEN REDUCTION AND INTERNAL FIXATION WITHOUT OPENING JOINT CAPSULE ON TIBIAL PLATEAU FRACTURE

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