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19 agosto 2014

Trauma: Ojo a las lesiones concomitantes en las fracturas de meseta tibial

Arthroscopy-Assisted Surgery for Tibial Plateau Fractures.
Chen XZ, Liu CG, Chen Y, Wang LQ, Zhu QZ, Lin P.
Arthroscopy. 2014 Aug 12

Abstract

PURPOSE:
This study aimed to summarize the recent clinical outcomes of patients undergoing arthroscopy-assisted reduction and internal fixation (ARIF) for tibial plateau fractures.

METHODS:
A systematic electronic search of the PubMed and Cochrane databases was performed in January 2014. All English-language clinical studies on tibial plateau fractures treated with ARIF that were published after January 1, 2000 were eligible for inclusion. Basic information related to the surgery was collected.

RESULTS:
The search criteria initially identified 141 articles, and 19 studies were included in this systematic review. There were 2 retrospective comparative studies, 16 case series studies, and one clinical series based on a technique note. There were a total of 609 patients in this systematic review, with a mean follow-up time of 52.5 months. The most common fracture types were Schatzker types II and III. Concomitant injuries were common: 42.2% of the patients had meniscal injuries, and 21.3% had anterior cruciate ligament (ACL) injuries. In addition, the status of 90.5% of the patients was classified as good or excellent according to the clinical Rasmussen scoring system, and 90.9% of the patients were satisfied with the treatment. Only 6 severe complications were reported, including one case of compartment syndrome.

CONCLUSIONS:
ARIF is a reliable, effective, and safe method for the treatment of tibial plateau fractures, especially when they present with concomitant injuries.

LEVEL OF EVIDENCE:
Level IV, systematic review of Level III and Level IV studies.

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