Short-term Efficacy of Robot-assisted Balloon Reduction and Percutaneous Palisade Screw Fixation in the Treatment of AO/OTA41B2 Tibial Plateau Fracture
Objective To investigate the short-term efficacy of robot-assisted combined balloon reduction and percutaneous"jail"screw fixation in the treatment of AO/OTA41B2 tibial plateau fracture.Methods A total of 29 patients with AO/OTA41B2 closed fracture admitted to our hospital from September 2019 to September 2022 were retrospectively analyzed.Among them,14 were male and 15 were female with average age of(44.17±9.53)years old(range 26-62 years old).The time from injury to operation was(6.48±4.08)days(range 2-20 days).All the surgical methods were treated by minimally invasive internal fixation with"Jail"technique screw after indirect reduction assisted by TiRobot.Standard anteroposterior and lateral radiographs of the knee were taken,the fracture reduction was evaluated according to the Rasmussen radiological score,and the knee function was evaluated using the Hospital for Special Surgery(HSS)score.The collapse volume of fracture area,lateral proximal tibial angle(LPTA)and lateral posterior proximal tibial angle(LPPTA)were compared before and after operation.CT was used to compare the difference between preoperative planning and actual positioning.Results All the 29 patients were followed up for(15.10±6.13)months(ranging from 10 to 24 months).Fracture healing time was(9.52±1.66)weeks(range 8 to 12 weeks).At 6th month after surgery,the Rasmussen score of the knee joint was(17.34±1.04)points(ranging from 14 to 18 points),of which 18 cases were excellent and 11 cases were good.Preoperative collapse volume of fracture site was(3.27±2.14)cm3(range 0.89-10.16 cm3),LPTA was 84.81°±6.08°(range 70°-92°),and LPPTA was 11.89°±14.16°(range-20°-26.8°),the collapse volume of the fracture area after surgery was(0.07±0.20)cm3(range 0-0.77 cm3),LPTA was 91.75°±0.62°(range 90°-92°),LPPTA was 7.45°±1.97°(range 0°-10°),and the difference was statistically significant(t=8.193,P＜0.001;t=-6.172,P＜0.001;t=1.854,P=0.037).Preoperative CT layout consisted of(1.56±0.32)cm(ranging from 1.11-2.28 cm),and(1.52±0.44)cm(ranging from 0.96-2.09 cm),while postoperative CT layout proved the actual parameters in coronal and sagittal position parameters[(1.56±0.31)cm(range 1.11-2.28 cm),(1.52±0.44)cm(range 0.94-2.10 cm)].There was no statistically significant difference(t=-0.256,P=0.400;t=-0.779,P=0.221).At the last follow-up,there were no serious complications such as common peroneal nerve injury,popliteal vascular injury,postoperative infection,and failure of internal fixation.Conclusion Robot-assisted balloon reduction combined with percutaneous"jail"screw fixation in the treatment of AO/OTA41B2 tibial plateau fracture has a satisfactory clinical effect.
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