Abstract
Background:
Tibial plateau fractures are complex injuries that demand meticulous surgical techniques to achieve anatomical reduction and stable fixation. Both ARIF and ORIF have been utilized for fracture management, each with its advantages and limitations. ARIF offers the potential for enhanced visualization, accurate reduction, and minimally invasive approaches. This review aims to assess the available evidence to determine whether ARIF offers superior outcomes compared to ORIF in tibial plateau fracture management.
Method:
A systematic search of relevant databases was conducted to identify case control studies comparing ARIF and ORIF for tibial plateau fractures. Inclusion criteria encompassed studies reporting KSS as an outcome measure. Quality assessment and data extraction were performed independently by two reviewers.
Result:
The systematic review identified a total of four case-control studies meeting the inclusion criteria with total of 261 patients with tibial plateau fractures. The sample sizes varied across the studies, with the smallest study including 40 patients and the largest study including 317 patients. The outcomes were assessed using various scoring systems, including IKDC scores, Lysholm scores, and KSS scores. The results consistently showed that ARIF had higher scores compared to ORIF, indicating better functional outcomes.
Conclusion:
ARIF holds promise as a superior technique compared to ORIF for managing tibial plateau fractures. ARIF offers enhanced visualization, more accurate reduction, and potentially faster postoperative recovery. However, individual patient and fracture characteristics must still be considered when determining the optimal surgical approach. Further high-quality prospective studies and long-term follow-up are warranted to confirm these findings and establish the broader applicability of ARIF in diverse tibial plateau fracture scenarios.