Comparison of arthroscopic reduction and percutaneous fixation and open reduction and internal fixation for tibial plateau fractures

Publication date: Available online 21 March 2018
Source:Injury
Author(s): Yufu Sun, Kai Sun, Wenxue Jiang
PurposeTo conduct a meta-analysis with randomized controlled trials (RCTs) published in full text to demonstrate database to show the associations of perioperative, postoperative outcomes of arthroscopic reduction and percutaneous fixation(ARPF) and open reduction and internal fixation(ORIF) for tibial plateau fractures to provide the predictive diagnosis for clinic.MethodsLiterature search was performed in PubMed, Embase, Web of Science and Cochrane Library for information from the earliest date of data collection to to June 2017. RCTs comparing the benefits and risks of ARPF with those of ORIF in tibial plateau fractures were included. Statistical heterogeneity was quantitatively evaluated by X² test with the significance set P< 0.10 or I² > 50%.ResultsSeven RCTs consisting of 571 patients were included.(288 ARPF patients; 283 ORIF patients;). Pooled results showed that ORIF was related to a greater increase in operative time, incision length, hospital stay, perioperative complications, and full weight bearing compared with ARPF. The results showed that ARPF was related to a greater increase in ROM Rasmussen Scores compared with ORIF (WMD = 10.38; 95% CI, 8.31, 12.45;P<0.10).ConclusionThis meta-analysis showed that arthroscopic reduction and percutaneous fixation for tibial plateau fractures, compared with open reduction and internal fixation, could demonstrate an decreased risk of perioperative and postoperative complications and improve clinical outcome in operative time, incision length, hospital stay, perioperative complications, full weight bearing and Rasmussen Scores.Level of evidence Therapeutic study, Level II.



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