Comparison of the Windowing and Open Book techniques in the treatment of tibial plateau fractures of Schatzker type Ⅱ
10.3760/cma.j.cn115530-20241104-00432
- VernacularTitle:"开窗"技术与"开卷"技术治疗Schatzker Ⅱ型胫骨平台骨折的疗效比较
- Author:
Tianming YU
1
;
Jichong YING
1
;
Jianlei LIU
1
;
Yunqiang ZHUANG
1
Author Information
1. 宁波市第六医院创伤骨科，宁波市骨科与运动康复临床医学研究中心，宁波 315040
- Publication Type:Journal Article
- Keywords:
Tibial fractures;
Knee joint;
Surgical procedures;
Prognosis;
Radiographic images
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(8):658-664
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the treatment efficacy between the Windowing and Open Book techniques in the treatment of tibial plateau fractures of Schatzker type Ⅱ.Methods:A retrospective study was performed to analyze the clinical data of the 211 patients with tibial plateau fracture of Schatzker type Ⅱ who had been treated by open reduction and internal fixation via the anterolateral knee incision at Department of Traumatic Orthopaedics, The Sixth Hospital of Ningbo from January 2014 to June 2022. There were 142 males and 69 females, with an age of (57.7±14.3) years. Based on the intraoperative reduction techniques, the patients were divided into 2 groups: a Windowing group ( n=107) in which reduction of the split bone fragments was followed by reduction of the depressed articular surface, and an Open Book group ( n=104) in which reduction of the depressed articular surface was followed by reduction of the split bone fragments. The following data were collected and compared between the 2 groups: preoperative general data, operative time, quality of fracture reduction, loss of fracture reduction, fracture healing rate at postoperative 6 months, visual analogue scale (VAS) pain score at postoperative 24 months, post-traumatic arthritis grading at the final follow-up (based on the Resnick-Niwoyam criteria), and Rasmussen classifications of knee function at postoperative 3 and 24 months. Results:There were no significant differences in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The follow-up period for all patients was (34.0±10.6) months. The operative time was (65.0±8.3) minutes for the Windowing group and (64.2±10.2) minutes for the Open Book group, showing no significant difference ( P>0.05). Postoperative CT scans revealed residual articular depression in 10 cases in the Windowing group and in 25 cases in the Open Book group, showing a significant difference ( P<0.05). However, there was no significant difference in plateau widening or varus/valgus alignment between the 2 groups ( P>0.05). There were no statistically significant differences between the 2 groups in loss of fracture reduction, fracture healing rate at postoperative 6 months, VAS score at postoperative 24 months, post-traumatic arthritis grading at the final follow-up, or Rasmussen classifications of the knee function at postoperative 3 or 24 months ( P>0.05). Conclusions:In the treatment of Schatzker type Ⅱ tibial plateau fractures, the Windowing technique demonstrates superior radiographic outcomes compared to the Open Book technique, but the 2 techniques show similar efficacy in functional evaluation and medium-term prognosis.
