关节镜下内固定术治疗胫骨上端骨折预后及其影响因素  

Arthroscopic assisted internal fixation for the treatment of upper tibial fractures

作　　者：任洪[1] 黄波[1] 庾明 王枰稀[1] 

机构地区：[1]达州市中心医院骨科,四川达州635000

出　　处：《临床和实验医学杂志》2016年第4期380-383,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨关节镜下内固定术治疗胫骨上端骨折的中远期疗效,并分析其影响因素。方法收集2008年1月至2010年1月行关节镜下内固定术治疗的胫骨上端骨折患者80例的临床资料,采用Lysholm评分、Irrgang评分、Rasmussen功能评分对入组患者膝关节功能进行评价,采用Rasmussen放射学评分及Ahlback分级对膝关节功能进行放射性评价。结果本组患者均随访至少48个月,有47.5%(38/80)的患者患侧出现股性关节炎,不同骨折类型之间,患者各项膝关节功能评分差异无统计学意义(P>0.05);年龄>60岁,伴有股骨侧、胫骨侧软骨损伤者及关节内软组织损伤者的Irrgang评分、Lysholm评分、Rasmussen评分、Rasmussen放射学评分及Ahlback分级增加值等各项膝关节功能评分均低于无上述类型损伤者,差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示:年龄、胫骨侧软骨损伤、股骨侧软骨损伤及关节内软组织损伤是影响关节镜下内固定术治疗胫骨上端骨折中远期疗效的主要因素。结论关节镜下内固定术治疗胫骨上端骨折的中远期疗效较好,年龄>60岁、伴胫骨、股骨侧软骨损伤及关节内软组织损伤是影响关节镜下内固定术治疗胫骨上端骨折中远期疗效的重要影响因素。Objective To evaluate the outcomes of upper tibial fractures after treated with arthroscopic assisted internal fixation,and analyze the influencing factors. Methods Between January 2008 and January 2010,with the information of the patients with upper tibial fractures undergoing arthoscopic assisted internal fixations were enrolled. The Lysholm score,Irrgang score,Rasmussen score and Ahlback osteoarthritis were assessed at 48 months after treated with internal fixations. Results All patients were followed- up for 48 months. At 48 months after surgery,47. 5%（ 38 /80） patients presented osteoarthritis. No correlation could be observed between the various types of fractures and their prognosis（P〈0. 05）. Logistic regression analysis revealed that age,tibia lateral cartilage injury,lateral femoral cartilage damage and Intraarticular soft tissue injuries were the independent factors for outcome. Conclusion Fixation under arthroscopy in the treatment of upper tibia fractures is an effective treatment. Age 〉60 years old,with tibial and femoral lateral cartilage injury and joint soft tissue injury is affected upper tibia fractures treated by internal fixation under arthroscopy.

关 键 词：胫骨上端骨折 关节镜 内固定术 

分 类 号：R687.3[医药卫生—骨科学]