Objective: To compare the clinical efficacy of modified dual plating and less invasive stabilization system for the treatment of complex tibial plateau fractures, and to analyse their effects on serum inflammatory cytokines, including interleukin-1 beta (IL-1β), interleukin -6 (IL-6) and Tumor Necrosis Factor alpha (TNF-α).
Methods: 240 patients of complex tibial plateau fractures in our hospital from February 2015 to February 2016 were selected as the research objects and divided into Groups A-C according to the different treatment, with 80 cases in each group. Patients in Group A received modified dual plating treatment, patients in Group B were treated with Less Invasive Stabilization system, and patients in Group C underwent unilateral locking plate internal fixation. Treatment effects, operation time, intraoperative blood loss, the length of hospital stay, healing time, and changes of serum IL-1β, IL-6, TNF-α levels before and after treatment were compared in three groups.
Results: After treatment, the excellent-effective rates of Groups A and B were 87.5% and 85% respectively, which were both significantly higher than that of Group C, but there were no significant differences between Groups A and B. There was no significant difference in the incidence of postoperative complications between Groups A-C. Both Groups A and B were better than Group C in operation time, the length of hospital stay, intraoperative blood loss and healing time, but there was no significant difference between Groups A and B. Before treatment, no significant difference of serum IL-1β, IL-6, TNF-α levels was found in Groups A-C. However, 7 d after treatment, serum IL-1, IL-6, TNF-α levels in Groups A and B were lower than that in Group C, but there was no significant difference between Groups A and B.
Conclusion: For the treatment of complex tibial plateau fractures, modified dual plating and less invasive stabilization system were both better than unilateral locking plate internal fixation in treatment effects. However, no significant differences were found in curative effects and lowering serum inflammatory factors levels of between Groups A and B.