Long-term follow-up of minimally invasive percutaneous plate osteosynthesis with double reverse traction repositor in patients with tibia plateau fracture: an analysis of at least seven years' outcomes.

Purpose: This study aimed to evaluate long-term radiological and functional outcomes in tibia plateau fractures (TPFs) patients treated using minimally invasive percutaneous plate osteosynthesis (MIPPO) and Double Reverse Traction Repositor (DRTR).

Methods: We reviewed 85 patients treated with MIPPO and DRTR at our hospital from January 2015 to December 2017. Radiologic outcomes, including tibial plateau angle (TPA), posterior slope angle (PSA), and Kellgren-Lawrence classification, were assessed, while functional outcomes were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form (SF)-36, and Hospital for Special Surgery Knee Score (HSS score). Data from medium follow-up (4.39 ± 0.58 years) and final follow-up (7.75 ± 0.53 years) were analyzed with the Wilcoxon signed-rank test.

Results: We included 65 patients with three(4.62%), 26(40.00%), eight(12.31%), six(9.23%), 11(16.92%), and 11(16.92%) were Schatzker I- VI, respectively. The mean follow-up time was 7.75 ± 0.53 years, with surgery performed in 5.72 ± 2.37 days post-injury and mean operation time of 96.72 ± 31.15 min. Short-term complications included two superficial infections (3.08%). Significant improvements in functional outcomes were observed at final follow-up: range of motion was 138.38° ± 8.49°, enhancements in WOMAC scores, HSS knee scores, and SF-36 (P < 0.05). No further progression of osteoarthritis was observed (K-L classification) during seven-year follow-up (P = 0.655).

Conclusions: MIPPO with DRTR is a promising and safe technique for the TPFs, leading to satisfactory outcomes up to seven years postoperatively, especially in reducing the incidence for knee osteoarthritis.