Comparison of the efficacy of two internal fixation modalities in the treatment of Schatzker type IV tibial plateau fracture
10.3760/cma.j.cn101721-20240326-00090
- VernacularTitle:两种内固定方式治疗Schatzker Ⅳ型胫骨平台骨折的效果比较
- Author:
Tianyu ZHANG
1
;
Lei WANG
Author Information
1. 河北省唐山市第二医院创伤四科，唐山 063000
- Keywords:
Tibial plateau fracture;
Extension of anterolateral incision;
Posteromedial incision;
Posterolateral column
- From:
Clinical Medicine of China
2024;40(5):335-339
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical effects of two fixation methods for the posterior lateral column of the tibial plateau: simple lateral plate fixation and posterior T-shaped plate combined with lateral plate fixation.Methods:A retrospective analysis was conducted on the clinical data of 90 patients with Schatzker IV tibial plateau fractures accompanied by posterior lateral structural damage at Dapartment of Trauma 4, Tangshan Second Hospital, Hebei Province from February 2019 to December 2022. Among them, 48 patients who were treated with lateral steel plate fixation alone were selected as the observation group, and 42 patients who were treated with posterior T-shaped steel plate combined with lateral steel plate fixation were selected as the control group. To compare the fracture healing time, surgical time, knee joint association score, and visual analog score between two groups of patients. T-test was used for inter group comparison of metric data that conforms to normal distribution (represeted by xˉ±s), and χ2 test was used for inter group comparison of count data. Results:The patients in both groups were followed up for a period of 18 to 30 months. During this period, there was no internal fixation failure, no fracture malunion, and no knee stiffness in both groups. Fracture healing time after treatment in the two groups ((3.94±1.42) months in the observation group vs. (3.86±1.32) months in the control group), KSS score ((172.31±16.91) points in the observation group vs. (168.95±15.78) points in the control group), VAS score comparison ((0.90±0.37) points in the observation group vs.(0.93±0.45) points in the control group), and the difference was not statistically significant ( t values were 0.28, 0.97 and 0.31, respectively; P values were 0.782, 0.335 and 0.757, respectively). The surgical time of the observation group patients ((84.58±12.32) minutes) was lower than that of the control group ((110.64±14.41) minutes), and the difference was statistically significant ( t=9.25, P<0.001). Conclusion:Although patients with Schatzker IV tibial plateau fracture with posterolateral column injury have achieved satisfactory clinical results with lateral plate fixation alone and posterior T-plate combined with lateral plate fixation, the use of lateral plate alone can reduce the operation time, reduce the difficulty of surgery, and reduce the risk of iatrogenic injury.
