To compare the clinical outcomes of double-incision double-plate internal fixation and unilateral locking plate internal fixation in the treatment of Schatzker V tibial plateau fracture.

A retrospective analysis of patients admitted to Huainan Xinhua Hospital of Xinhua Medical Group from May 2016 to May 2019. A total of 54 patients with Schatzker V tibial plateau fractures were included. According to different surgical methods, 30 cases of double-incision double steel plate internal fixation were included in the observation group, and 24 cases of single-sided locking steel plate internal fixation were included in the control group. The chi-square test, continuous correction chi-square test t test were used to compare the two groups of perioperative and postoperative recovery indicators (intraoperative blood loss, discharge time, total length of incision, operation time, knee functional exercise start time, full weight-bearing exercise time, fracture healing time). The varus angle (TPA), posterior angle (PA) and range of motion (ROM) of the knee joint after the operation, and at the postoperative 12 months were evaluated by the the Hospital for Special Surgery (HSS) knee scoring system to assess the patients’ knee joint function and the presence or absence of postoperative complications.

There was no significant difference in intraoperative blood loss, discharge time, total incision length, and operation time between the observation group and the control group (P>0.05). the start time of knee functional exercise in the observation group was significantly shorter than that of the control group (t=20.549, P<0.05). the observation group exercise time under full load (t=20.549, P<0.05) and fracture healing time (t=20.095, P<0.05) were significantly longer than the control group. There was no significant difference between the observation group and the control group in TPA, PA and ROM after operation and 12 months after operation (P>0.05). There was no significant difference in the HSS excellent and good rate of the observation group and the control group (χ²=0.244, P>0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (χ²=4.351, P<0.05).

Both double-incision double plate internal fixation and unilateral locking plate internal fixation for Schatzker V type can obtain satisfactory therapeutic effects. The double-incision double-plate internal fixation scheme can be used for early rehabilitation training after knee joint surgery due to its advantages such as accurate reduction and firm fixation, thereby effectively reducing the occurrence of postoperative knee joint stiffness.