Efficacy of Arthroscopic Minimally-Invasive Internal Fixation for Tibial Plateau Fractures, and Its Effect on Pain Stress

Abstract

Background: Tibial plateau fractures are complex injuries caused by high or low energy trauma, usually accompanied by soft tissue damage. Staged treatment is strongly encouraged for complex fracture types. Traditionally, open reduction and internal fixation (ORIF) is mostly performed through an anterolateral approach, but this is usually traumatic. The present study was carried out to evaluate the efficacy of arthroscopic minimally-invasive internal fixation for tibial plateau fractures, and to determine its effect on pain stress. Methods: Patients with tibial plateau fractures diagnosed and treated in our hospital from January 2020 to December 2021 were subjected to eligibility assessment, out of which 70 patients were eventually included in the study. The subjects were assigned to two groups: ORIF (control group) and arthroscopic minimally-invasive internal fixation (observation group), with 35 patients in each group. Clinical indices, functional recovery, postoperative pain, and stress indices were measured and compared between the 2 groups. Results: The observation group had significantly smaller surgical wound, less intraoperative bleeding, shorter time-lapse before off-bed activity, and faster fracture healing than the control (ORIF) (p < 0.05). Patients in the observation group had significantly higher postoperative Rasmussen scores and Lysholm scores, and lower VAS (visual analogue scale) scores than those in control group (p < 0.05). Moreover, the observation group had significantly lower levels of substance P, neuropeptide Y, and prostaglandin E2 than the control group (p < 0.05). Conclusions: Arthroscopic minimally-invasive internal fixation surgery was less invasive, and it resulted in faster recovery of functionality in patients with tibial plateau fractures, than ORIF. Moreover, it reduced postoperative pain and stress. Therefore, the procedure may provide a good prognosis for tibial plateau fractures.