| Objective:Tibial plateau fractures are mostly caused by high-energy injuries.They are fractures involving articular surface and mainly comminuted fractures,which are difficult to rreduce and with severe soft tissue injuries.There are more or less limitations in previous methods of reduction,and traditional open reduction and internal fixation aggravate soft tissue injury.In order to improve reduction quality,decrease operation time and treat tibial plateau fracture with minimally invasive technique,our hospital developed lower limb axial tractor.In this study,the data of patients with tibial plateau fractures treated in our hospital were retrospectively analyzed,to discuss the advantages and disadvantages of the treatment of tibial plateau fractures with axial tractor and open reduction with traditional manual traction.Methods:The data of 89 patients with tibial plateau fractures who underwent surgical treatment from July 2013 to July 2018 were retrospectively analyzed.According to the different treatment schemes,they were divided into group A and group B.Group A was treated with manual traction.There were 40 patients,29 males and 11 females,aged 29-77 years,with an average age of(50.1± 13.2)years,7 patients in Schatzker type Ⅳ,17 patients in Schatzker type V and 16 patients in Schatzker type VI.In group B,49 patients,33 males and 16 females,aged 30-68 years,were treated with axial tractor.The average age was(48.9±9.5 years),including 8 patients in Schatzker typeⅣ,21 patients in Schatzker type Ⅴ and 20 patients in Schatzker type VI.The operation time,intraoperative bleeding and knee joint function and et al were recorded and analyzed statistically.Results:For Schatzker type Ⅳ fractures,the use of axial traction reduces intraoperative time and intraoperative bleeding.There were significant differences between the two groups in terms of surgery time,intraoperative bleeding,postoperative knee function.However,there is no significant difference in alignment and excellent rate.For Schatzker type Ⅴ fractures,there were significant differences in the operation time and intraoperative bleeding between the two groups.There was not a statistically significant difference between the knee joint function and the excellent rate.For Schatzker type Ⅵ fractures,there were significant differences in the operation time and intraoperative bleeding between the two groups.There was not a statistically significant difference between the knee joint function and the excellent rate.There was no significant difference between the two groups.From the postoperative statistical results,the postoperative complication rate was 47.5%in group A and 14.3%in group B,with statistical significance(p=0.001,p<0.05).The post-infection rate was 20%.and was 4.1%in group B,which is statistically significant(p=0.018,p<0.05).Postoperative thrombosis rate was 10%in group A,and was 4.1%in group B,and there was no statistical significance(p=0.268,p>0.05).Conclusion:The axial traction device for lower limb fracture has the characteristics of easy to install,strong traction force and enlarged operation space.It can not only reduce the fracture,but also maintain the position of the fracture pieces after anatomical reduction,and reduce the number of surgical participants.It is suitable for treatment of complex tibial plateau fractures.The use of tractor treatment can reduce the operation time,reduce intraoperative bleeding,and reduce the damage of the patient;for complex tibial plateau fractures,the use of the tractor significantly shortens the operation time,and it is more convenient to reset the fracture,With the help of MIPO technologym,it can reduce intraoperative bleeding and damage to soft tissue.We also believe that the use of the tractor reduces the infection rate and makes the bone shape after fracture reduction closer to the original anatomy,although there is no significant difference in statistics. |
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