OBJECTIVE: To evaluate the effectiveness and safety of minimally invasive treatment for bilateral tibial plateau fractures using the double reverse traction reducer. METHODS: The clinical data of 4 patients with bilateral tibial plateau fractures who met the selection criteria and treated between January 2016 and April 2024 were retrospectively analyzed. The cohort included 3 males and 1 female, aged 30-65 years (mean, 52.5 years). Injury mechanisms comprised traffic accidents (2 cases) and falls (2 cases). According to the Schatzker classification, 2 limbs were type Ⅱ and 6 were type Ⅵ. The time from injury to surgery ranged from 5 to 9 days (mean, 7 days). All patients underwent minimally invasive reduction using the double reverse traction reducer. Surgical duration, intraoperative blood loss, and hospitalization time were recorded. Functional outcomes were assessed at last follow-up using the Hospital for Special Surgery (HSS) knee score and range of motion (ROM), while fracture reduction quality was evaluated using the Rasmussen radiological score. RESULTS: All 4 patients successfully completed the procedure without conversion to open reduction. The total mean operation time was 80.25 minutes (range, 73-86 minutes), with a mean total intraoperative blood loss of 132.5 mL (range, 100-150 mL). The mean hospitalization time was 13.5 days (range, 11-16 days). All incisions healed primarily without neurovascular complications. X-ray film at 1 day after operation confirmed satisfactory reduction and articular surface alignment. Follow-up time ranged from 12 to 26 months (mean, 17.0 months). Fractures achieved clinical union at an average of 13 weeks (range, 12-16 weeks). No complication, such as deep vein thrombosis, joint stiffness, post-traumatic arthritis, or implant failure, was observed. At last follow-up, the mean HSS score was 92.9 (range, 90-97), mean knee ROM was 128.1° (range, 115°-135°), and mean Rasmussen radiological score was 16.4 (range, 15-19), with 2 limbs rated as excellent and 6 as good. CONCLUSION The double reverse traction reducer facilitates minimally invasive treatment of bilateral tibial plateau fractures with advantages including minimal trauma, shorter surgical duration, precise reduction, and fewer complications, effectively promoting fracture healing and functional recovery of the knee joint.
Humans ; Tibial Fractures/diagnostic imaging* ; Middle Aged ; Male ; Minimally Invasive Surgical Procedures/instrumentation* ; Female ; Adult ; Retrospective Studies ; Aged ; Traction/methods* ; Treatment Outcome ; Fracture Fixation, Internal/instrumentation* ; Range of Motion, Articular ; Operative Time ; Tibial Plateau Fractures

BACKGROUND: Vascular smooth muscle cell(VSMC) is one of the major cell components of vascular wall and its pathologic effects in atherosclerosis has been verified and recognized. How to inhibit VSMC proliferation and migration becomes one of the hotspots in the researches regarding the prevention of coronary heart disease(CHD).OBJECTIVE: To observe the impacts of diethyl-2, 6-diethyl-4-furny-1,4-dihydropyridine-3, 5-dicarboxylate(EFDP) on angiotensin Ⅱ (Ang Ⅱ)-induced VSMC proliferation.DESIGN: A randomized controlled study based on VSMC of rabbit' s thoracic aorta cultured in vitro.SETTING: Department of cardiology in a military medical university of Chinese PLA.MATERIALS: The study was conducted in the Laboratory of Cardiology of Xijing Hospital of the Fourth Military Medical University of Chinese PLA between August 2003 and June 2004. Five New Zealand rabbits were selected for the harvest of VSMC. Animal cells were randomly divided into control group, Ang Ⅱ group and Ang Ⅱ + EFDP group(EFDP group).METHODS: New Zealand rabbits were fed by high-fat food. Thoracic aorta was harvested for the separation and culture of VSMC after the injury in thoracic aorta intima by sacculus. The experiment introduced the cultured rabbit VSMC to observe the impacts of EFDP on VSMC DNA synthesis and its time effect during VSMC proliferation promoted by Ang Ⅱ by 3H-TdR method.MAIN OUTCOME MEASURES: 3H-TdR intensity of radio activity in cells of each group to display the DNA synthesis during VSMC proliferation process.RESULTS: Ang Ⅱ could promote the synthesis of rabbit VSMC DNA, which hit its peak at the 36th hour compared with that of control group(358. 00± 49.01 vs 272.42 ± 54.96, P ＜ 0. 01 ) . EFDP had significant inhibitive effects on Ang Ⅱ-induced VSMC proliferation, which also displayed a significant dose-dependent relationship, i.e. with the elevation of EFDP concentration, its inhibitive rate on VSMC proliferation also gradually increased. At the 36th hour, 78.40 μ mol/L of EFDP had more significant effect than that of 0. 08 μmol/L of EFDP(281.50 ± 15.28 vs 349. 25 ±32.10, P＜ 0. 05).CONCLUSION: EFDP can significantly inhibit Ang Ⅱ-induced rabbit VSMC proliferation with certain dose-effect dependency and time responses,which provides a theoretical gist for the primary rehabilitative prevention of atherosclerosis.