A. Panda1, W. Rodriguez1, V. Panchbhavi1 1University Of Texas Medical Branch, Department Of Orthopaedic Surgery And Rehabilitation, Galveston, TX, USA
Introduction:
Tibial plateau fractures are complicated fracture patterns that typically arise from high-energy trauma injuries such as motor vehicle accidents. The incidence of tibial plateau fractures is 10.3 per 100,000 people annually with males under 50 years of age being the most common patient. Using arthroscopic-guided surgery for treatment not only allows for a less invasive procedure, but also allows surgeons to visualize the chondral surfaces and provide imaging for the reduction of the fracture site. This study evaluates the post-surgical complications associated with open vs. arthroscopically-aided treatment of tibial fractures.
Methods:
TriNetX, a global health database with deidentified patient information, was used and analyzed for this study. Cohort A was defined as patients who had an arthroscopically-aided treatment of tibial fractures, proximal (plateau); unicondylar or bicondylar, including internal fixation, (Current Procedural Terminology [CPT]: 29855, 29856). Cohort B was defined as patients who had open treatment of tibial fractures, proximal (plateau); unicondylar or bicondylar, including internal fixation, (CPT: 27535, 27536). Data were gathered from healthcare organizations from the past 10 years. All post-diagnostic complications were analyzed between 1 and 120 days after the surgical treatment.
Results:
1,027 patients in cohort A were propensity matched with 22,162 patients in cohort B for age at event, ethnicity, race, sex, type 2 diabetes mellitus, alcohol dependence, nicotine dependence, and body mass index. Patients who underwent arthroscopically-aided treatment of tibial fractures experienced a lower associated risk fornumerous post-operative complications. When compared to open treatment patients, arthroscopically-aided treatment patients had decreased risk for wound disruption (RR 0.313, 95% CI 0.154 – 0.632), acute procedural pain (RR 0.463, 95% CI 0.319 – 0.674), future tibial fractures (RR 0.284, 95% CI 0.216 – 0.372), revision open treatment surgery (RR 0.185, 95% CI 0.095 – 0.362), pulmonary embolism (RR 0.455, 95% CI 0.216 – 0.955), and skin infection (RR 0.382, 95% CI 0.203 – 0.72) 120 days following the procedure
Conclusion:
This propensity-matched study showed that patients who had arthroscopically-aided treatment of tibial fractures experienced lower associated risk for numerous post-operative complications compared to patients who had open treatment of tibial fractures.