Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

Abstract

Instead of extensive dissection of soft tissue around the fracture site, percutaneous techniques have unique advantages in managing displaced fragments, including preservation of soft tissues, less blood loss, lower risk of complications, and earlier functional rehabilitation. However, there are few systematic reviews on the effects of percutaneous reduction and internal fixation (PRIF) for tibial plateau fractures. A systematic search of Cochrane, EMBASE, and MED-LINE databases was performed for all publicly available data in March 2017 regarding the use of PRIF in treating monocondylar tibial plateau fractures. Basic information of included articles, surgical information, clinical outcomes, and concomitant soft tissue injuries were collected for analysis. Finally, a total of 20 articles including 561 patients were retrieved. Traffic accident was the most common cause of injury. Percutaneous techniques using bone tamp reduction were described in all studies. The majority (≥85%) of patients were classified as excellent or good according to clinical and radiological Rasmussen scores. The overall complication rate was 6.6%, with loss of reduction the most frequent complication with an incidence of 2.4%. This systematic review indicated that PRIF was an optimal alternative that physicians should consider for the treatment of monocondylar tibial plateau fractures.

Retracted: An Often Easily Missed Injury in the Presence of Orthopaedic Trauma: A Case Series of Derived Injury

“…We should have a focus, because the process of prevention may cause irritation and interference to the surrounding soft tissues. We should make necessary treatment to the injury to minimize the derived injury, including hemostasis of the blood vessel injury, cold compress for soft tissue contusion, homeopathic treatment, and fixation of the external stent for fracture. On the basis of homeopathic treatment, the irritation and interference to soft tissues should be reduced to the minimum.…”

Management and Complications of Condylar Fractures

“…A variation of CRIF is the percutaneous reduction and internal fixation (PRIF). PRIF involves making a small incision in the skin and then using specialized instruments to reduce and fix the fracture without the need for a larger incision (10). PRIF offers the advantages of both ORIF and CRIF, including direct visualization of the fracture site and less invasive surgery.…”

Surgical Approaches and Leg Positions for Tibial Plateau Fractures

“…Percutaneous reduction should be made with a bone tamp, with percutaneous application of bone-holding forceps, and with the joystick technique and ligamentotaxis [18].…”

“…The 6.5-7.3 mm cannulated screws are then placed parallel to the articular line. According to the literature, the minimal number of screws required for this procedure is three [18]. Washers are a good choice for better compressing the fracture line.…”