CHEN Zhongyao 1,2,3 , DU Xing 1,2,3 , LUO Gang 1,2,3 , TANG Dagang 1,2,3 , WANG Xinyi 1,2,3 , LI Yiyang 1,2,3 , SUN Kangwen 1,2,3 , DUAN Yi 4 , SHUI Wei 1,2,3
  • 1. Department of Orthopaedic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;
  • 2. Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine, Chongqing, 400016, P. R. China;
  • 3. Orthopaedic Research Laboratory of Chongqing Medical University, Chongqing, 400016, P. R. China;
  • 4. Department of Orthopedics, Chongqing Qijiang Central Hospital, Chongqing, 409099, P. R. China;
SHUI Wei, Email: sjuiwei@163.com
Posterolateral tibial plateau fracture; robot; arthroscopy; minimally invasive treatment; short-term effectiveness
10.7507/1002-1892.202505004
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Objective  To investigate short-term effectiveness of robot-assisted fracture reduction and fixation combined with arthroscopic exploration for posterolateral depressed tibial plateau fractures. Methods  Between January 2022 and January 2024, 8 patients with posterolateral depressed tibial plateau fractures (Schatzker type Ⅲ) were treated using robot-assisted fracture reduction and fixation combined with arthroscopic exploration, with simultaneous treatment of concomitant ligament or meniscus tears. There were 3 males and 5 females with an average age of 54.1 years (range, 42-68 years). Injury mechanisms included traffic accidents (3 cases) and falls (5 cases). The time from injury to operation ranged from 2 to 4 days (mean, 3.1 days). Operative time, intraoperative blood loss, hospital stay, visual analogue scale (VAS) score for pain, and complications were recorded. Fracture healing and knee Rasmussen scores were assessed radiographically, while knee function was evaluated using range of motion and Hospital for Special Surgery (HSS) scores. Results  All operations were successfully completed. The operative time was 108-129 minutes (mean, 120.1 minutes). The intraoperative blood loss was 10-100 mL (mean, 41.3 mL). The hospital stay duration was 4-7 days (mean, 5.6 days). All incisions healed by first intention without complications such as peroneal nerve injury, vascular damage, or infection. All patients were followed up 32-48 weeks (mean, 40.0 weeks). Radiographic follow-up confirmed that the knee Rasmussen scores rated as excellent in 8 patients and all fractures healed with the healing time of 12-16 weeks (mean, 13.5 weeks). The VAS score for pain was 2-4 (mean, 2.8) at discharge and improved to 0 at 1 month. The knee range of motion was 80°-110° (mean, 96.1°) at discharge and increased to 135°-140°(mean, 137.9°) at 1 month after operation. At 3 months after operation, the HSS score was 91-94 (mean, 92.8), all graded as excellent. No severe complications, including implant failure, occurred during follow-up. Conclusion  For posterolateral depressed tibial plateau fractures, the minimally invasive approach combining robot-assisted fracture reduction and fixation with arthroscopic exploration demonstrates multiple advantages, including shorter operative time, reduced intraoperative blood loss, excellent wound healing, fewer complications, and rapid recovery of knee function. This technique achieves satisfactory short-term effectiveness, while its long-term effectiveness requires further evaluation.

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