关节镜下及切开复位治疗胫骨平台骨折  

The Treatment of Tibial Plateau Fractures with Arthroscopy or Open Reduction

作　　者：郑延贵[1] 历文华[1] 黄明[1] 胡德康[1] 卓巍[1] 冯磊[1] 

机构地区：[1]蚌埠第三人民医院骨科,233000

出　　处：《解剖与临床》2004年第4期254-256,共3页Anatomy and Clinics

摘　　要：目的 :探讨关节镜下或切开手术治疗胫骨平台骨折的临床疗效。方法 :38例胫骨平台骨折的病人按骨折类型分为两组 :A组 12例为SchatzkerⅠ型、Ⅱ型和Ⅲ型 ,在关节镜下手术 ;B组为SchatzkerⅣ型、Ⅴ型和Ⅵ型 ,共 2 6例 ,行切开复位内固定手术。结果 :随访 13～ 36个月 ,平均 2 6个月。按Rasmussen评分标准 ,A组优 8例、良 4例 ,B组优 9例、良 11例、可 6例。结论 :关节镜下治疗SchatzkerⅠ型、Ⅱ型和Ⅲ型胫骨平台骨折创伤小 ,是一种有效的治疗方法 ;对SchatzkerⅣ型、Ⅴ型和Ⅵ型高能量损伤 ,既要注意解剖复位 ,亦要重视软组织损伤的处理 ,可降低术后并发症 ,有利病人康复。Objective:To study the effect of treating tibial plateau fractures with arthroscopy or open reduction.Methods:38 patients with tibial plateau fractures were reviewed.12 patients with of tibial plateau fractures of Schatzker's type Ⅰ,Ⅱ and Ⅲ were performed the operation with arthroscopy technique (group A).The other 26 patients with tibial plateau fractures of Schatzker's type Ⅳ,Ⅴ and Ⅵ were treated with opened reduction (group B).Results:All the patients were followed up for a mean time of 26 months(range,13～36months).According to Rasmussen' criterion,the outcone was excellent in 8 cases and good in 4 in group A.The outcome was excellent in 9 cases,good in 11 and fair in 6 in group B.Conclusion:For the tibial plateau fractures of Schatzker's type Ⅰ,Ⅱ and Ⅲ,arthroscopy technique is effective.For tibial plateau fracures of Schatzker's type Ⅳ,Ⅴ and Ⅵ caused by high-energy injuries,anatomic reduction and conditions of soft tissue should be emphasized to avoid complications,which is beneficial for the patients to recover.

关 键 词：关节镜 胫骨平台骨折 切开复位内固定手术 解剖复位 软组织损伤 

分 类 号：R687.3[医药卫生—骨科学]