Comparative study on the efficacy of structural support fixation vs. conventional fixation for depressed tibial plateau fractures
Bibliographic record
Abstract
PURPOSE: To compare the clinical outcomes of structural support fixation vs. conventional fixation for depressed tibial plateau fractures (TPFs). METHODS: A retrospective analysis was conducted on patients who underwent surgical treatment for depressed TPFs at our hospital between November 2019 and September 2023. Forty-six patients with TPFs who had surgical indications were included. Based on the surgical procedures, patients were categorized into the structural support group receiving locking plate + cage fixation, and the conventional group receiving locking plate + granular bone grafting. The following parameters were evaluated and compared, including operative time, blood loss, time to full weight-bearing, fracture healing time, loss of tibial plateau height, quality of fracture reduction and alignment, hospital for special surgery knee score, and Western Ontario and McMaster Universities Osteoarthritis Index score. Intergroup differences were analyzed using independent-sample t-tests or the rank-sum test. RESULTS: A total of 46 eligible patients completed the follow-up (20 in the structural support group, 26 in the conventional group). No significant differences were observed between the 2 groups in the mean age, sex, body mass index, injury mechanism, or time from injury to surgery (p = 0.276, 0.860, 0.615, 0.160, 0.065, respectively). The mean operative time was 120.7 min in the structural support group and 164.2 min in the conventional group, with the mean blood loss of 120.0 mL and 168.5 mL, respectively. Neither operative time nor blood loss showed significant differences (p = 0.067 and p = 0.309). The mean follow-up duration was 20.2 months (structural support group) and 20.4 months (conventional group), with no significant difference (p = 0.987). At the final follow-up, the structural support group exhibited significantly less secondary step-off compared to the conventional group (0.3 mm vs. 0.7 mm, p < 0.001). While hospital for special surgery functional scores showed no significant difference (94.1 vs. 88.1, p = 0.066), the structural support group had significantly better Western Ontario and McMaster Universities Osteoarthritis Index scores (1.4 vs. 6.3, p = 0.001), with superior outcomes in pain, stiffness, and functional difficulty subscales (p = 0.009, 0.004, 0.003, respectively). No adverse events (e.g., infection, nonunion, or refracture) were found in both groups. CONCLUSION: Compared to conventional fixation, locking plate combined with cage effectively reduces secondary step-off in depressed TPFs and significantly improves pain relief and knee function.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".