关节镜监视与切开复位钢板内固定治疗低能量胫骨平台骨折的疗效比较  

Effect comparison of steel plate fixation between under arthroscope and open reduction for treatment of low energy tibial plateau fracture

作　　者：王玮[1] 金先跃[2] 庄小强[1] 白宇[1] 刘德淮[1] 

机构地区：[1]广西民族医院骨科,广西南宁530001 [2]广西壮族自治区人民医院骨科,广西南宁530021

出　　处：《中国内镜杂志》2013年第4期359-362,共4页China Journal of Endoscopy

基　　金：广西崇左市科研课题(科技成果登记号:201191458)

摘　　要：目的探讨关节镜监视与切开复位钢板内固定治疗低能量胫骨平台骨折的临床疗效。方法 50例低能量胫骨平台骨折,治疗组及对照组均25例,均为SchatzkerⅠ型10例,Ⅱ型8例,Ⅲ型7例。采用关节镜监视下复位钢板内固定25例,对照组25例行切开复位钢板内固定(无关节镜监视,切开关节囊)。结果 50例随访12～24个月,平均18个月,所有骨折均获骨性愈合,患膝按照Lysholm膝关节评分标准,治疗组:优20例(80.0%),良3例(12.0%),可2例(8.0%),总体优良率92.0%;对照组:优,17例(68.0%),良5例(20.0%),可2例(8.0%),差1例(4.0%),总体优良率88.0%。并对两组患者术后6、12个月患膝功能的评分进行统计学分析,术后6个月两组评分结果差异无显著性(P>0.05),术后12个月两组患膝评分结果差异有显著性(P<0.05)。结论关节镜监视下比切开复位钢板内固定临床疗效好,不打开关节囊,同时还能处理关节内并发伤及其他疾病,骨折复位更满意,手术创伤小,关节功能恢复更快、更好,并发症少。[Objective] To investigate the clinical effect of steel plate fixation between under arthroscope and open reduction for treatment of low energy tibial plateau fracture.[Methods] Fifty patients of low energy tibial plateau fracture were divided into two groups.Each group had 25 patients.There were 10 cases in typeⅠof Schatzker,8 cases in type Ⅱ,7 cases in type Ⅲ.Twenty-five patients of treatment group were fixed under arthroscope including 14 male and 11 female,with an average age of 42 years ranging from 18 to 68 years.25 patients of control group were treated with open internal fixation including 17 male and 8 famale,with an average age of 41 years ranging from 19 to 65 years.[Results] 50 patients were followed up for 6 to 24 months,mean 12 months.All the fractures got the bone union.The effect were evaluated by Lysholm calcification,the rate of treatment group was 20 excellent（80.0%）,3 good （12.0%） and 2 fair（8.0%）,the rate of excellent heal was 92%,the rate of control group was 17 excellent（68.0%）,5 good （20.0%） and 2 fair （8.0%）,and 1 case was poor（4.0%）,the rate of excellent heal was 88.0%.The statistical analysis revealed no statistically significance compared with the score at six months later after operation （P 0.05）,with statistically significance compared with the score at twelve months later after operation （P 0.05）.[Conclusion] The clinical effect of internal fixation with steel plate under arthroscope is better than that of the other group.Operation under arthroscope didn＇t open the joint capsule,and it can treat the other injury and disease,it has the advantage of the fracture replacement,the surgical trauma is reduced,the complication is fewer.The joint functional recovery is faster and better.

关 键 词：胫骨平台骨折 关节镜 切开复位 钢板内固定 

分 类 号：R683.41[医药卫生—骨科学]