Tibial plateau fractures: compared outcomes between ARIF and ORIF

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomechanical Engineering

Background:

• Tibial plateau fractures are complex injuries requiring precise surgical management.
• Arthroscopic assisted reduction internal fixation (ARIF) and open reduction internal fixation (ORIF) are common surgical techniques.
• Comparing the efficacy and outcomes of ARIF versus ORIF is crucial for optimizing patient care.

Purpose of the Study:

• To compare the clinical and radiological outcomes of ARIF and ORIF in patients with tibial plateau fractures.
• To evaluate the effectiveness of ARIF and ORIF across different Schatzker classifications of tibial plateau fractures.
• To assess complication rates, including infections, associated with both ARIF and ORIF.

Main Methods:

• A comparative study of 100 patients with tibial plateau fractures, divided into ARIF (Group A) and ORIF (Group B) groups.
• Patients were evaluated using X-rays, CT scans, and clinical assessments (Rasmussen and HSS scores).
• Follow-up ranged from 12 to 116 months, with analysis of early and late complications.

Main Results:

• No significant differences in clinical or radiological scores were observed between ARIF and ORIF for Schatzker type I fractures.
• ARIF demonstrated potentially improved clinical outcomes for Schatzker type II-III-IV fractures.
• Both ARIF and ORIF showed poor medium- to long-term results for Schatzker type V and VI fractures, but ARIF had a lower infection rate.

Conclusions:

• ARIF and ORIF show comparable results for Schatzker type I tibial plateau fractures.
• ARIF may offer superior clinical outcomes for Schatzker type II-III-IV tibial plateau fractures.
• For complex fractures (Schatzker V-VI), ARIF is the preferred choice due to a lower infection risk, despite similar long-term functional results.