ĐÁNH GIÁ KẾT QUẢ PHẨU THUẬT XÂM LẤN TỐI THIỂU ĐIỀU TRỊ GÃY KÍN MÂM CHÀY BẰNG NẸP VÍT KHOÁ TẠI BỆNH VIỆN QUÂN Y 7A

Abstract

Objective: To evaluate the clinical and radiological outcomes as well as complications of minimally invasive plate osteosynthesis (MIPO) using locking compression plates in the treatment of closed tibial plateau fractures. Materials and Methods: A retrospective–prospective descriptive study was conducted on 45 patients with closed tibial plateau fractures (Schatzker types III–VI) treated at the Department of Orthopedic Trauma, 7A Military Hospital, from January to July 2025. All patients underwent closed reduction under C-arm guidance followed by fixation with locking plates through small skin incisions. Outcomes were assessed using the Visual Analog Scale (VAS), operative time, range of motion (ROM), Lysholm score, WOMAC index, Rasmussen score, bone healing time, and postoperative complications. Results: The mean age was 43.8 ± 13.3 years; 62.2% were female. The mean operative time was 73.42 ± 7.44 minutes. The mean postoperative VAS pain score was 4.27 ± 2.71. ROM was rated “good/excellent” in 80% of cases. According to the Lysholm scale, 78% achieved “good/excellent” outcomes, while the mean WOMAC score was 30.69 ± 24.45 (median = 24). Approximately 80% achieved bone union within 10–12 weeks. Rasmussen functional outcomes were “excellent/good” in 95.1% of patients (excellent = 75.6%, good = 19.5%). No major complications, implant failure, or infections were observed; 82.9% of patients had supple scars, and 17.1% had mild hypertrophic scars. Conclusion: MIPO with locking plates for closed tibial plateau fractures (Schatzker III–VI) provided good functional recovery, early bone union, and a low complication rate, confirming it as a safe and effective surgical technique in clinical practice.