| Objective To compare the clinical efficacy and safety of knee arthroscopy combined with MIPPO reduction and internal fixation with open reduction and internal fixation in the treatment of tibial plateau fractures. Methods Included in this retrospective study were 76 patients who had been admitted in Taihe Hospital from July 2018 to July 2020 for Schatzker type Ⅰ - Ⅲ tibial plateau fracture. According to the different surgical plans, they were divided into knee arthroscopy combined with MIPPO minimally invasive internal fixation group (group A, 35 cases) and traditional open reduction and internal fixation group (group O, 41 cases). The two groups were compared in terms of operation time, incision length, intraoperative blood loss, postoperative drainage, soft tissue injury in the knee joint hospital stay, postoperative ambulation, postoperative Rasmussen radiation score, fracture healing time, postoperative complications, knee function HSS score at 1, 2, 3 and 6 months after operation, and the excellent and good rate of HSS score at 12 months after operation. Results The operation time of group A was longer than that of group O, the number of patients with soft tissue injury in the knee joint of group A was more than that of group O, and the difference was statistically significant (P<0.05). The intraoperative blood loss and postoperative drainage in group A were significantly lower than those in group O, with statistically significant differences (P<0.05). The incision length, postoperative ambulation and fracture healing time in group A were significantly shorter than those in group O, with statistically significant differences(P<0.05). There was no significant difference between the two groups in hospital stay (P>0.05). The postoperative Rasmussen radiation score in group A was significantly higher than that in group O, with statistically significant differences (P<0.05). The knee function HSS score at 1, 2, 3 and 6 months after operation in group A was significantly higher than that in group O, with statistically significant differences (P<0.05). There was no significant difference between the two groups in the excellent and good rate of knee function HSS score at 12 months after operation. Conclusion Both surgical methods have achieved good clinical efficacy in the treatment of tibial plateau fractures of Schatzker types Ⅰ - Ⅲ . However, in the treatment of tibial plateau fracture with the assistance of knee arthroscopy combined with MIPPO technique, the injured soft tissue of knee joint can be diagnosed and treated accurately, which has the advantages of smaller surgical trauma, clearer view of operation, good quality of fracture reduction, shorter fracture healing time and faster recovery of knee joint function. It is beneficial to the early recovery of patients after operation, and is a good method for the treatment of Schatzker type Ⅰ-Ⅲ tibial plateau fractures. |
