Clinical Study Of Zhang’s Homeopathic Minimally Invasive Reductor In The Treatment Of Posterolateral Tibial Plateau Fracture

Objective:Posterolateral tibial plateau fracture is a rare type of tibial plateau fracture.Currently,open reduction and internal fixation surgery has many problems such as severe iatrogenic surgical injuries and postoperative complications.In order to solve the above problems,we developed a device called Zhang’homeopathic minimally invasive reductor for treatment of posterolateral fracture of the tibial plateau.The purpose of this study was to investigate the reliability and clinical efficacy of this method in the treatment of this type of fracture.Methods:A retrospective study was performed in 19 patients admitted to the trauma center of the hospital of Hebei medical university who suffered posterolateral tibial plateau fractures from November 2015 to July 2017.The operation time,intraoperative blood loss,postoperative complications,articular surface collapse depth,articular surface widening value,tibial plateau angle,and posterior tilt angle were collected.Patients were followed up regularly,and the complications of postoperative patients were recorded in detail.The data of articular surface collapse depth,articular surface widening value,tibial plateau angle and posterior tilt angle were measured.Rasmussen clinical scores and Rasmussen imaging scores were used for efficacy evaluation at the last follow-up.Results:Nineteen patients with posterolateral tibial plateau fractures were included in the study.The mechanism of injury:9 cases of car accidents,6 cases of falls from high,3 cases of sprains,and one case of fall.There were17 male and 2 female patients,with 18~62 years old.The average operation time was 129±40.4 min,and the intraoperative blood loss was 210±73.6 ml.The mean value of articular surface collapse depth was 1.55±0.92 mm immediately after surgery;the average articular surface widening was1.71±1.89 mm immediately after surgery.There was a significant difference between the preoperative and postoperative articular surface collapse depth and articular surface widening(P~1<0.01).The mean postoperative TPA was88.74°±2.45°;the mean postoperative PSA was 10.95°±3.84°.At the last follow-up,the mean depth of articular surface collapse was 1.60±0.94mm;the mean value of articular surface widening was 1.91±1.73 mm.There was no significant difference in the mean depth of articular surface collapse and articular surface widening between the postoperative and the last follow-up(P~2=0.067,P~2=0.731).The mean TPA at the last follow-up was 88.47°±2.84°;the mean PSA was 11.05°±4.31°.There was no significant difference in the mean values of TPA and PSA between the postoperative and the last follow-up(P~2=0.761,P~2=0.937).At the last follow-up,the patient’s mean Rasmussen imaging score was 14.74±1.48(12~18),with 3 excellent patients(15.8%),and 14 good patients(73.7%).The average Rasmussen clinical score was27.00±2.90(19~30),of which 12 excellent patients(63.2%)and 6 good patients(31.6%).Conclusions:The use of homeopathic minimally invasive reductor for the treatment of posterolateral tibial plateau fractures has the characteristics of shorter operation time,low rate of postoperative complications,and low rate of iatrogenic injuries.