AbstractSection Purpose

Minimally invasive surgery is the mainstream for traumatic orthopaedics, especially for those intra-articular fractures. This study aims to identify the factors that influence the effectiveness of a novel minimally invasive reduction technique in treating tibial plateau depression fractures.

AbstractSection Methods

A retrospective analysis was performed on prospectively collected data on patients presenting with a tibial plateau depression fracture who subsequently received the minimally invasive treatment using a novel technique, i.e., bone graft reduction technique combined with a bone tamp impactor instrument between March 2021 and March 2023. Based on the postoperative residual articular surface depression depth in mm through arthroscopic examination, patients were classified as having post-ADD ≤ 2 mm or ADD > 2 mm. Baseline and clinical characteristics between the two groups were compared and their effect on residual ADD was examined using multivariable logistic regression analyses.

AbstractSection Results

A total of 173 patients, including 88 males (51%) and 85 females (49%) with an average age of 50.17 ± 14.48 years were enrolled in the study protocol. Univariate analyses showed significant differences between groups in terms of age, BMI, time from injury to operation, duration of operation time, blood loss, pre-ADD, pre-MPTA, pre-PTSA, ligament injury and Schatzker classification. Multivariable logistic regression analysis revealed that older age (OR = 1.128, 95%CI = 1.055–1.205, P = 0.000), higher BMI (OR = 1.314, 95%CI = 1.080–1.598, P = 0.006), higher pre-ADD (OR = 4.179, 95%CI = 1.196–14.598, P = 0.025), Schatzker type V (OR = 25.976, 95%CI = 2.348-287.385, P = 0.008) and VI (OR = 13.247, 95%CI = 1.076-163.047, P = 0.044) were significantly associated with the reduction effectiveness.

AbstractSection Conclusion

We identified age, BMI, pre-ADD, Schatzker type V and VI as independent risk factors. These findings would help risk assessment and stratification, target risk factor modification and clinical surveillance, and inform patient counseling.