Journal of Hebei Medical University ›› 2025, Vol. 46 ›› Issue (3): 309-316.doi: 10.3969/j.issn.1007-3205.2025.03.011

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Double reverse traction versus open reduction for tibial plateau fractures: A Meta-analysis

  

  1. 1.Department of Trauma, the First Affiliated Hospital of Baotou Medical College, Inner Mongolia 
    Autonomous Region, Baotou 014010, China; 2.The First Clinical School of Inner Mongolia 
    Medical University, Hohhot 010110, China

  • Online:2025-03-25 Published:2025-03-27

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Abstract: Objective To compare the therapeutic outcomes of double reverse traction-assisted minimally invasive closed reduction with plate fixation and open reduction with plate fixation in the treatment of tibial plateau fractures. 
Methods Constructed search equations to search across databases such as PubMed, Cochrane Library, EMbase, Web of Science, and Chinese databases including CNKI, Wanfang, VIP, and the China Biomedical Literature Service System for literature on the treatment of tibial plateau fractures via double reverse traction-assisted minimally invasive closed reduction and open reduction. The timeframe for our search was from the inception of these databases until April 2024. Two separate researchers conducted the literature quality assessment and data extraction, with data analysis performed using RevMan 5.3 software. 
Results Our study encompasses seven articles, involving a total of 511 patients, of whom 234 were treated with the minimally invasive method and 277 with the open reduction method. The findings indicated that the minimally invasive group demonstrated superior outcomes in terms of intraoperative blood loss (MD=-2.55, 95%CI: -3.94--1.17, P＜0.01), length of hospitalization (MD=-0.54, 95%CI: -0.75--0.33, P＜0.01), Hospital for Special Surgery (HSS) score (MD=0.71, 95%CI: 0.50-0.910, P＜0.01), fracture healing time (MD=-0.39, 95%CI: -0.70--0.08, P=0.01), incidence of complications (OR=0.30, 95%CI: 0.16-0.57, P＜0.01), and wound complications (OR=0.26, 95%CI: 0.10-0.68, P=0.006) when contrasted with the open reduction group. However, both techniques showed comparable duration of operation (MD=0.03, 95%CI: -1.54-1.61, P＞0.05), postoperative weight-bearing time (MD=-0.92, 95%CI: -2.14--0.3, P=0.14) or the incidence of deep vein thrombosis in the lower limbs (OR=0.78, 95%CI: 0.31-2.00, P=0.61). 
Conclusion Double reverse traction-assisted minimally invasive closed reduction plate fixation presents enhanced efficacy in the management of tibial plateau fractures relative to open reduction withplate internal fixation. 


Key words: tibial fractures, double reverse traction device, minimally invasive closed reduction