Arthroscopic reduction and fixation of Schatzker type Ⅳ tibial plateau fracture plus posterolateral column collapse assisted by an anterior cruciate ligament tunnel locator
10.3760/cma.j.cn115530-20250218-00070
- VernacularTitle:关节镜下前交叉韧带隧道定位器辅助复位固定在Schatzker Ⅳ型胫骨平台合并后外侧柱塌陷骨折中的应用
- Author:
Tao LI
1
;
Junhong LI
1
;
Jianhua JI
1
;
Hongjie WEN
1
;
Peng LIAO
1
;
Qinggang ZHAO
1
;
Hang ZHAO
1
;
Zhong CHEN
1
Author Information
1. 云南大学附属医院骨与创伤外科，昆明 650021
- Publication Type:Journal Article
- Keywords:
Arthroscopy;
Fracture fixation, internal;
Surgical procedures, minimally invasive;
Tibial plateau fracture
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(11):935-942
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical effects of an anterior cruciate ligament (ACL) tunnel locator applied in the arthroscopic reduction and fixation of Schatzker type Ⅳ tibial plateau fracture plus posterolateral column collapse.Methods:A retrospective study was conducted to analyze the clinical data of 12 patients with Schatzker type IV tibial plateau fracture combined with posterolateral column collapse who had undergone arthroscopic reduction and fixation assisted by an ACL locator at Department of Orthopedics and Trauma Surgery, The Hospital Affiliated to Yunnan University from January 2020 to December 2022. There were 8 males and 4 females with an age of (44.5±6.4) years (set as an observation group). According to a 1∶1 ratio, another contemporary 12 patients of the same category were selected as a control group who had been treated by double-plate-screw fixation through internal and external double incisions. They were 7 males and 5 females with an age of (42.6±6.3) years. The operation time, incision length, intraoperative blood loss, postoperative hospital stay, and postoperative complications were recorded and compared between the 2 groups. At the same time, the Rasmussen radiological and functional scores at 1, 3, and 12 months after operation were recorded for intergroup and intragroup comparisons.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing the 2 groups were comparable ( P>0.05). All the 24 patients were followed up for (18.2±3.5) months after operation. In the observation group, the operation time [(96.3±6.3) min], incision length [(8.5±0.6) cm], and postoperative hospital stay [(8.1±1.3) d] were significantly shorter than those in the control group [(128.2±7.5) min, (15.9±0.8) cm, and (9.3±1.2) d], and the intraoperative blood loss [50.0 (41.5, 59.0) mL] was significantly less than that in the control group [135.0 (121.5, 147.5) mL] (all P<0.05). However, intergroup comparisons showed no statistically significant differences in Rasmussen radiographic scores or functional scores at 1 month, 3 months, or 12 months postoperatively between the 2 groups ( P>0.05). Additionally, no significant differences were observed in postoperative complications between the 2 groups ( P>0.05). Conclusions:In the arthroscopic reduction and fixation of Schatzker type Ⅳ tibial plateau fracture plus posterolateral column collapse, compared with the traditional double-plate-screw fixation through double incisions, assistance of an ACL tunnel locator leads to advantages of being more minimally invasive and more surgically efficient. However, the 2 techniques lead to comparable postoperative functional recovery.
