Comparison of the clinical results of different approaches in the treatment of Schatzker V and VI tibial plateau fractures

Abstract

Abstract In order to compare the clinical effects of different access surgical approaches in the treatment of Schatzker type V and VI tibial plateau fractures, a total of 68 patients with Schatzker type V and VI tibial plateau fractures involving the posterior-lateral aspect admitted to our hospital from January 2020 to January 2022 were grouped based on the different surgical access approaches, of which Patients treated with medial combined posterior-lateral approach were recorded as Group A (n=34), and patients treated with posterior medial inverted L incision combined with anterior-lateral approach were recorded as Group B (n=34). The surgical indexes (operation time, intraoperative blood loss) of the two groups were observed and compared, and the clinical efficacy of the patients was evaluated based on the New York Surgical Hospital (HSS) scores and imaging review, as well as the postoperative complications and the quality of life of the patients. Through the experiment, the operation time and intraoperative blood loss index of group A were better than that of group B (P < 0.05); the HSS scores of the two groups were significantly improved with time (P < 0.05), and at the same time, based on the follow-up observation, there was no significant difference between the HSS scores of the two groups of patients in the period of 3, 6, and 12 months of follow-up (P > 0.05); up to the time of the last follow-up visit, the patients of the two groups had received the imaging examination, and no The mean knee range of motion in group A was 126. 32°±5. 48° (0-7°; 114-139°), and the mean knee range of motion in group B was 127.56°±6.78° (0-10°; 113-140°), and there was no statistically significant difference in the knee range of motion between the two groups (t=0.05). Range of motion was not statistically different (t=0.829, P=0.409); the incidence of postoperative complications in Group A was 14.71% (5/34) was slightly higher than the incidence of postoperative complications in Group B was 11.76% (4/34), but this difference was not significant (x2=0.128, P=0.720); the quality of life of patients in the two groups was improved over time (P<0.05) and based on the SF36 scale score at 6 and 12 months of follow-up there was no significant difference in the quality of life between the two groups (P > 0.05). The above results showed that the operation time and intraoperative bleeding of the medial combined posterior-lateral approach were less than that of the posterior medial inverted L incision combined anterior-lateral approach. Still, there was no significant difference between the two in terms of clinical efficacy and safety. The choice of surgical approach should be determined by combining the characteristics of fracture morphology, the objective conditions of instrumentation, and the patient’s individuality.