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Wang Y, Wang Z, Tian S, Zhang J, Chen W, Zheng Z, Zhang Y. Double reverse traction repositor assisted closed reduction and internal fixation versus open reduction and internal fixation for treatment of lateral tibial plateau fractures among the elderly. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02561-4. [PMID: 38789856 DOI: 10.1007/s00068-024-02561-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/17/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND In elderly tibial plateau fractures (TPFs), the lateral condyles are involved frequently. This study aimed to compare the outcomes of open reduction and internal fixation (ORIF) and double reverse traction repositor (DRTR) assisted closed reduction and internal fixation (CRIF) in elderly patients with lateral TPFs. METHODS From January 2015 to July 2020, we retrospectively reviewed 68 patients treated surgically at our trauma center for lateral TPFs (Schatzker type I-III). 31 patients were eventually assigned to the DRTR assisted CRIF group, whereas 37 patients were assigned to the ORIF group. The primary outcomes included surgical details, radiological assessment, follow-up knee function, and complications. RESULTS The DRTR assisted CRIF group experienced a 43.6 mL decrease in intraoperative blood loss (161.3 ml vs 204.9 ml, p = 0.033), and the operation duration was 32.1 min shorter than the ORIF group (83.8 min vs 115.9 min, p < 0.001). There was no statistically significant difference in terms of widening of the tibia plateau (WTP), depth of articular depression (DAD), medial proximal tibial angle (MPTA) and posterior tibial slope angle (PTSA) immediately after surgery and at the last follow-up. No differences in malreduction (p = 0.566) or reduction loss (p = 0.623) were observed between the groups, and Lysholm and HSS scores were similar between the two groups (83.6 ± 15.8 vs 83.4 ± 5.1, p = 0.934; 89.3 ± 7.8 vs 86.9 ± 6.2, p = 0.172; respectively). However, ORIF was associated with a greater increase in postoperative complications than DRTR assisted CRIF (3.2% vs 27%, p = 0.008). CONCLUSION Both types of internal fixation provide good radiological outcomes and knee function in the treatment of lateral TPFs in the elderly. However, DRTR assisted CRIF has the advantage of a shorter duration of surgery, less blood loss, and fewer postoperative complications, and appears to be a better treatment option for elderly patients with lateral TPFs.
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Affiliation(s)
- Yuchuan Wang
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China
- Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- NHC Key Laboratory of Intelligent Orthopeadic Equipment, Shijiazhuang, 050051, Hebei, P. R. China
| | - Zhongzheng Wang
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China
- Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- NHC Key Laboratory of Intelligent Orthopeadic Equipment, Shijiazhuang, 050051, Hebei, P. R. China
| | - Siyu Tian
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China
- Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- NHC Key Laboratory of Intelligent Orthopeadic Equipment, Shijiazhuang, 050051, Hebei, P. R. China
| | - Junzhe Zhang
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China
- Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- NHC Key Laboratory of Intelligent Orthopeadic Equipment, Shijiazhuang, 050051, Hebei, P. R. China
| | - Wei Chen
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China
- Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- NHC Key Laboratory of Intelligent Orthopeadic Equipment, Shijiazhuang, 050051, Hebei, P. R. China
| | - Zhanle Zheng
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China
- Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China
- NHC Key Laboratory of Intelligent Orthopeadic Equipment, Shijiazhuang, 050051, Hebei, P. R. China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China.
- Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.
- NHC Key Laboratory of Intelligent Orthopeadic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.
- Chinese Academy of Engineering, Beijing, 100088, P.R. China.
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Wang B, Zhu Y, Zhang B, Wang Y, Yan L, Xie X, Luo C. Incidence and Characteristics of Knee Ligament and Meniscal Injuries in Patients With Posterolateral Tibial Plateau Fractures. Orthop J Sports Med 2024; 12:23259671241238023. [PMID: 38601191 PMCID: PMC11005506 DOI: 10.1177/23259671241238023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 09/18/2023] [Indexed: 04/12/2024] Open
Abstract
Background Anterior cruciate ligament (ACL) tears are commonly seen with concomitant injuries to the posterolateral tibial plateau, while the occurrence of ACL injuries in posterolateral tibial plateau fractures (PTPFs) remains unclear. Purpose To (1) explore the incidence of knee ligament (anterior or posterior cruciate ligament, medial or lateral collateral ligament) and medial or lateral meniscus injuries in patients with PTPF and (2) find reliable PTPF-related parameters to predict the risk of knee ligament and meniscal injuries. Study Design Cross-sectional study; Level of evidence, 3. Methods Patients diagnosed with PTPF who had computed tomography and magnetic resonance imaging (MRI) data were identified. Morphological parameters of the PTPF were measured on sagittal computed tomography images. Knee ligament and meniscal injuries were assessed using MRI. The association of ACL injuries with meniscal injuries was analyzed. Receiver operating characteristic (ROC) analysis was used to determine the value and cutoff point of the PTPF morphological parameters for diagnosing complete in-substance ACL tears. Results Overall, 113 patients with PTPF were included. ACL injuries were present in 94 (83.2%) patients, including 43 (38.1%) avulsion fractures and 28 (24.8%) complete in-substance tears. Patients with in-substance ACL tears had a higher incidence of lateral meniscus posterior horn tears compared with the other patients (PBonferroni < .001). ROC analysis revealed that both the fracture depression angle (cutoff point, 25.5°) and the posterior articular surface loss percentage (cutoff point, 37.5%) had a sensitivity >90% and a specificity >80% for the diagnosis of complete in-substance ACL tears. Conclusion ACL injuries were seen in 83.2% of the study patients. Complete in-substance ACL tears were associated with an increased incidence of lateral meniscus posterior horn tears. Among PTPF parameters, fracture depression angle and posterior articular surface loss percentage showed a high predictive value for the presence of complete in-substance ACL tears, thereby reducing delays in diagnosis and treatment.
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Affiliation(s)
- Binghao Wang
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Zhu
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Binbin Zhang
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yukai Wang
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lifeng Yan
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuetao Xie
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Congfeng Luo
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Fan M, Fang Y, Zhang Q, Zhao J, Liu B, Tian W. A prospective cohort study of the accuracy and safety of robot-assisted minimally invasive spinal surgery. BMC Surg 2022; 22:47. [PMID: 35148734 PMCID: PMC8832639 DOI: 10.1186/s12893-022-01503-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/31/2022] [Indexed: 01/02/2023] Open
Abstract
Background Robot-assisted open surgery (RA-OS) is now commonly used in traditional open-exposure spinal screw placement surgery. With the help of robots, robot-assisted minimally invasive surgery (RA-MIS) can achieve less bleeding and less tissue damage in percutaneous screw insertion. While the research comparing the safety and accuracy of screw placement between RA-MIS and RA-OS is insufficient. This study aims to compare the effects of RA-MIS and RA-OS in thoracic and lumbar spine. Methods This was a prospective cohort study evaluating 208 patients undergoing robot-assisted screw insertions from July 2020 to September 2021. Age, BMI, gender, screws accuracy, screws Gertzbein–Robbins grade, small joint invasion and perioperative outcomes (operation time, blood loss, postoperative hospital stay, comorbidity) were collected. A subgroup analysis was also performed according to disease, namely fracture, spondylolisthesis, and disc herniation. Data were analyzed using Stata/MP 14.0. Wilcoxon’s signed rank test, Kruskal–Wallis test and Fisher’s exact test were used for statistical tests and p < 0.05 was considered statistically significant. Results A total of 1030 screws were inserted; 368 minimally invasive screws and 662 open screws. The acceptability of screw insertion in the RA-MIS and RA-OS was 97.3% and 95.6% respectively. There was no statistical difference between the RA-MIS group and RA-OS group in age (p = 0.106), gender (p = 0.074), BMI (p = 0.181) and comorbidity (p = 0.203). Compared with RA-OS, RA-MIS had less blood loss (p < 0.001) and shorter postoperative hospital stay (p = 0.008). In the minimally invasive surgery group, the fracture subgroup had smaller screw deviation, less blood loss, and shorter operation time compared with the other subgroups (p < 0.01). Specifically, RA-MIS significantly reduced the postoperative hospital stay of patients with spondylolisthesis compared with RA-OS (p < 0.01). Conclusion RA-OS and RA-MIS had equal accuracy and safety. Compared with open surgery, minimally invasive surgery reduced blood loss in each subgroup and shortened the postoperative hospital stay in the spondylolisthesis subgroup. Compared with the other subgroups under minimally invasive surgery, the fracture subgroup had less blood loss and shorter operation time. Clinical trial registration: NCT04040868. Registered 1 March 2019, https://clinicaltrials.gov/ct2/show/NCT04040868?cond=Accuracy+Study+of+Robot-assisted+Screw+Insertion+in+Spinal+Surgery&draw=2&rank=1.
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Affiliation(s)
- Mingxing Fan
- Spine Department, Beijing Jishuitan Hospital, Beijing, China.,Beijing Key Laboratory of Robotic Orthopaedics, Beijing, China
| | - Yanming Fang
- Spine Department, Beijing Jishuitan Hospital, Beijing, China.,Beijing Key Laboratory of Robotic Orthopaedics, Beijing, China
| | - Qi Zhang
- Spine Department, Beijing Jishuitan Hospital, Beijing, China.,Beijing Key Laboratory of Robotic Orthopaedics, Beijing, China
| | - Jingwei Zhao
- Spine Department, Beijing Jishuitan Hospital, Beijing, China.,Beijing Key Laboratory of Robotic Orthopaedics, Beijing, China
| | - Bo Liu
- Spine Department, Beijing Jishuitan Hospital, Beijing, China.,Beijing Key Laboratory of Robotic Orthopaedics, Beijing, China
| | - Wei Tian
- Spine Department, Beijing Jishuitan Hospital, Beijing, China. .,Beijing Key Laboratory of Robotic Orthopaedics, Beijing, China.
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Ojeda-Thies C, Cuarental-García J, Ramos-Pascua LR. Decreased volume of hip fractures observed during COVID-19 lockdown. Eur Geriatr Med 2021; 12:759-766. [PMID: 33481186 PMCID: PMC7820835 DOI: 10.1007/s41999-020-00447-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 12/28/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The aim was to study the incidence and characteristics of fragility hip fractures admitted during COVID-19 lockdown. MATERIALS AND METHODS We analysed socio-demographic and baseline characteristics of patients suffering fragility hip fractures between March 1st and May 1st 2020, period most affected by COVID-19 confinement measures. Cases (n = 64) were compared with controls (n = 172) from corresponding periods in 2018 and 2019. Poisson Generalised Linear Model regression analysis was performed to compare daily case counts, and LOESS curves compared time series. RESULTS No differences were found regarding age or gender distributions, pre-fracture living, ambulatory, functional or cognitive status. More patients in 2020 had a high-risk ASA score. Fewer cases [Reduction = 26% (95% CI 1-44%)] were admitted in 2020. The reduction seemed to correspond with confinement. CONCLUSIONS Approximately, one quarter less fragility hip fractures were admitted to our hospital during lockdown. Patients' baseline status and socio-demographic characteristics were similar.
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Affiliation(s)
- Cristina Ojeda-Thies
- Department of Traumatology and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Avda Córdoba s/n, 28041, Madrid, Spain.
| | - Javier Cuarental-García
- Department of Traumatology and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Avda Córdoba s/n, 28041, Madrid, Spain
| | - Luis Rafael Ramos-Pascua
- Department of Traumatology and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Avda Córdoba s/n, 28041, Madrid, Spain
- Department of Surgery, School of Medicine, Complutense University of Madrid, Madrid, Spain
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Deng X, Hu H, Zhang Y, Liu W, Song Q, Cheng X, Zhu J, Yang S, Ye Z, Guan H, Zhang B, Zheng Z, Zhang Y. Comparison of outcomes of ORIF versus bidirectional tractor and arthroscopically assisted CRIF in the treatment of lateral tibial plateau fractures: a retrospective cohort study. J Orthop Surg Res 2021; 16:289. [PMID: 33941204 PMCID: PMC8091768 DOI: 10.1186/s13018-021-02447-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Lateral tibial plateau fractures (TPFs) are often treated with conventional open reduction and internal fixation (ORIF) through standard anterolateral sub-meniscal arthrotomy. There has been increasing support for “bidirectional rapid redactor” device-assisted closed reduction and internal fixation (CRIF) for treating TPFs. The aim of the present study is to compare the clinical and radiological outcomes between CRIF and ORIF procedures. Methods We performed a retrospective cohort study of 55 lateral TPF patients (Schatzker types I–III) who accepted surgical treatment at our trauma level 1 center between January 2016 and January 2018. They were divided into the CRIF group (32 patients) and the ORIF group (23 patients) based upon the different surgical protocols. The patients’ clinical outcome analysis was evaluated by using the Knee Society Score (KSS) and Rasmussen’s clinical score. For radiological assessment, changes in tibial plateau width (TPW), articular depression depth (ADD), medial proximal tibial angle (MPTA), and posterior tibial slope angle (PTSA) were evaluated using radiographs and computed tomography (CT) scan. Results The CRIF group had a mean follow-up of 28.9 months, and the ORIF group had a mean follow-up of 30.7 months (p>0.05). Furthermore, there was no statistically significant difference in terms of age, gender, injury mechanism, follow-up time, time interval from injury to surgery, and Schatzker classification in the two groups. With respect to the clinical outcomes including the KSS score and Rasmussen’s clinical score, there was also no significant difference (p>0.05). Nevertheless, the CRIF group had lower intra-operative blood loss, shorter hospitalization days, and better range of movement of the knee joint than the ORIF group (p<0.05). Furthermore, CRIF had better radiological results when compared to the ORIF group using Rasmussen’s radiological score (p<0.05), although no significant difference was observed in TPW, ADD, MPTA, and PTSA between the two groups (p>0.05). Conclusion The present study showed that CRIF could achieve comparable clinical outcomes and better radiological results for treating lateral TPFs as compared with conventional ORIF.
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Affiliation(s)
- Xiangtian Deng
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Hongzhi Hu
- Department of Orthopedics, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Yiran Zhang
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Weijian Liu
- Department of Orthopedics, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Qingcheng Song
- Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Xiaodong Cheng
- Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Jian Zhu
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China
| | - Sifan Yang
- Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Zhipeng Ye
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Haitao Guan
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Boyu Zhang
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Zhanle Zheng
- Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Yingze Zhang
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China. .,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China. .,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China. .,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.
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Deng X, Hu H, Wang Y, Shao D, Zhang Y. Arthroscopically assisted evaluation of frequency and patterns of meniscal tears in operative tibial plateau fractures: a retrospective study. J Orthop Surg Res 2021; 16:117. [PMID: 33549145 PMCID: PMC7868009 DOI: 10.1186/s13018-021-02265-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/26/2021] [Indexed: 11/18/2022] Open
Abstract
Background Despite tibial plateau fractures are often associated with meniscal tears, the association between meniscal tears and Schatzker classification remains unclear. The purpose of this study was to assess the frequency and patterns of meniscal tears in operatively treated tibial plateau fractures following immediate arthroscopic evaluation after internal fixation of tibial plateau fractures and to reveal the association between these concomitant meniscal tears and Schatzker classification. Methods A total of 252 consecutive patients (166 males and 86 females, mean age 46.7 (19–80) years) with operatively treated tibial plateau fractures admitted to our hospital from January 2016 to May 2019 were performed. Arthroscopic examination for frequency and patterns of meniscal tears was evaluated and documented at the time of surgery, and the association between the frequency and patterns of meniscal tears with Schatzker classification was then analyzed. Results The overall frequency of meniscal tears in TPFs was 67% (168 of 252) with 33% (84 of 252) of these being lateral meniscal tears, and 10% (26 of 252) medial meniscal tears, while 23% (58 of 252) had bilateral meniscal tears. Schatzker II was most commonly associated with meniscal tears, occurring in 72% (71 of 99) of our series. There is no significant difference between the frequency of meniscal tears and Schatzker classification (p > 0.05). The most common patterns of meniscal tears were longitudinal tears in 23% of tibial plateau fractures (59 of 252), and it occurred at a significantly higher frequency in Schatzker II with 43% (43 of 99). Schatzker IV had significantly higher prevalence of bucket-handle tears than other fracture patterns (p < 0.05), and Schatzker VI fractures had significantly higher prevalence of complex tears than other fracture patterns (p < 0.05). For other Schatzker classification, the patterns of meniscal tears demonstrated no statistical difference (p > 0.05). Conclusion The results identified that meniscal tears are commonly seen in each Schatzker classification. Although various patterns of meniscal tears occurred in tibial plateau fractures, the most common patterns were longitudinal tears. Importantly, we suggest that the status of meniscal tears associated with TPFs should be considered at the time of surgery in addition to fracture fixation.
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Affiliation(s)
- Xiangtian Deng
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China
| | - Hongzhi Hu
- Department of Orthopedics, The Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yuchuan Wang
- Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 430022, China
| | - Decheng Shao
- Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 430022, China
| | - Yingze Zhang
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China. .,Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 430022, China.
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