关节镜辅助下应用AO围关节解剖锁定钢板微创术治疗胫骨平台重度粉碎骨折的效果  

Clinical effect of minimally invasive treatment of severe comminuted fracture of tibial plateau with AO joint anatomic locking plate under arthroscope

作　　者：吴悦[1] 

机构地区：[1]大连大学附属中山医院骨科,116000

出　　处：《中国综合临床》2016年第3期248-250,共3页Clinical Medicine of China

摘　　要：目的观察关节镜辅助下应用AO围关节解剖锁定钢板微创术与传统内固定术治疗胫骨平台重度粉碎骨折的临床效果。方法选择2013年6月至2015年6月我院收治的胫骨平台重度粉碎骨折患者36例，患者均接受关节镜辅助下AO围关节解剖锁定钢板微创术。同时纳入35例同期在我院进行传统内固定术的患者作为对照组。观察两组患者手术时间、术中出血量、切口长度及肢体缩短、膝关节屈曲度、膝关节HSS评分等。结果研究组手术时间、术中出血量、切口长度分别为（95．1±20．4）min、（385．4±40．7）ml、（1．9±0．7）cm，对照组分别为（77．6±14．3）min、（456．7±45．1）ml、（4．0±1．2）cm，两组比较差异均有统计学意义（t值分别为4．175、6．997、9．038，P均〈0．05）；研究组患者肢体缩短、膝关节屈曲度分别为（0．9±0．7）mm、（112．1±14．8）°，对照组分别为（2．5±1．8）mm、（90．1±10．6）°，两组比较差异均有统计学意义（t值分别为4．962、7．183，P均〈0．05）；研究组治疗后膝关节HSS评分为（84．9±9．7）分，对照组为（69．1±7．3）分，两组比较差异有统计学意义（t=7．738，P〈0．05）。结论关节镜辅助下应用AO围关节解剖锁定钢板微创治疗胫骨平台重度粉碎骨折具有良好的临床疗效，对患者的创伤较小，术后恢复情况优于传统内固定术，且可以促进神经功能的恢复。Objective To observe the clinical effect of minimally invasive with AO joint anatomic locking plate under arthroscope and traditional internal fixation on treatment of severe comminuted fracture of tibial plateau. Methods Thirty-six cases of patients with severe comminuted fracture of tibial plateau were treated in Zhongshan Hospital Affiliated to Dalian University from June 2013 to June 2015 were selected. All patients received minimally invasive treatment with AO joint anatomic locking plate under arthroscope. At the same time, 35 cases of patients under traditional fixation were selected as the control group. General surgery information including operation time, intraoperative blood loss, length of incision, limb shortening, knee flexion degree and knee HSS score of patients in both two groups were observed. Results The operation time, intraoperative blood loss,length of incision of the research group were （ 95.1 ±20.4） min, （ 385.4 ±40. 7） ml and （ 1.9±0. 7 ） cm respectively, （ 77.6 ± 14. 3 ） min, （ 456. 7± 45.1 ） ml and （ 4.0± 1.2） cm for the control group, the differences were significant （ t = 4. 175,6. 997,9. 038 ; P 〈 0. 05 ）. The limb shortening, knee flexion degree of the research group were （0.9±0.7） mm and （ 112. 1± 14. 8） °respectively, （ 2. 5± 1.8） mm and （ 90. 1± 10. 6） ° for the control group, the differences were significant（ t = 4. 962,7. 183;P〈0.05）. After treatment, the knee joint HSS score of the research groups was （84. 9±9. 7）, （69. 1±7. 3） for the control group,the difference was significant（t=7. 738,P〈0.05）. Conclusion The clinical effect of minimally invasive treatment of severe comminuted fracture of tibial plateau with AO joint anatomic locking plate under arthroscope is significant, with smaller invasion, better postoperative recovery than traditional fixation, and can promote the recovery of neural function.

关 键 词：关节镜 AO围关节解剖锁定钢板 胫骨平台骨折 

分 类 号：R683.05[医药卫生—骨科学]