Minimally invasive robot-assisted treatment of tibial plateau fractures of Schatzker types Ⅱ and Ⅲ that can be indirectly reduced
10.3760/cma.j.cn115530-20240311-00110
- VernacularTitle:骨科手术机器人辅助下微创治疗可间接复位的Schatzker Ⅱ、Ⅲ型胫骨平台骨折的疗效分析
- Author:
Fei XIAO
1
;
Wenping HE
;
Junwen WANG
;
Jing JIAO
;
Ming CHEN
;
Yucheng HUANG
;
Keke CHENG
;
Tianrun LEI
Author Information
1. 武汉市第四医院骨科，武汉 430033
- Keywords:
Tibial fractures;
Surgery, computer-assisted;
Fracture fixation, internal;
Robotics
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(7):604-610
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the advantages of minimally invasive internal fixation assisted by an orthopedic robot in the treatment of tibial plateau fractures of Schatzker types Ⅱ and Ⅲ that can be indirectly reduced.Methods:A retrospective study was conducted of the 18 patients who had been treated for tibial plateau fractures of Schatzker types Ⅱ and Ⅲ at Department of Orthopaedics, The Fourth Hospital of Wuhan from December 2019 to December 2021. They were 12 males and 6 females with an age of (45.2±9.6) years. All fractures were closed. Of them, 6 were complicated with an avulsion fracture at the insertion point of the anterior cruciate ligament, 1 with tear of the medial collateral ligament, and 8 with tear of the lateral meniscus. All patients were treated with minimally invasive internal fixation using the "fence" screw technique after indirect reduction assisted by an orthopedic surgical robot. Those combined with avulsion fracture of the anterior cruciate ligament and meniscus tear underwent one-stage arthroscopic surgery, while those combined with tear of the medial collateral ligament underwent one-stage open repair. The fracture reduction was evaluated according to the Rasmussen radiological scoring system, and the knee joint function evaluated using the American Hospital for Special Surgery (HSS) scoring system.Results:All the 18 patients were fully followed up for (10.6±1.9) months. The X-ray films immediately after surgery showed good fracture reduction. The fractures healed after (11.3±1.2) weeks. At 6 months after surgery, the Rasmussen knee score was (16.8±1.0) points, giving 5 excellent and 13 good cases; the HSS score was (93.2±3.0) points, giving 17 excellent and 1 good cases. By the last follow-up, no serious complications occurred, such as common peroneal nerve injury, popliteal vascular injury, postoperative infection, or internal fixation failure.Conclusion:Since minimally invasive internal fixation assisted by an orthopedic robot can lead to fine clinical efficacy for tibial plateau fractures of Schatzker types Ⅱ and Ⅲ, this technique can be widely applied in clinical practice.
