经皮球囊扩张与开放复位内固定治疗SchatzkerⅢ型胫骨平台骨折的效果比较  

The effect of percutaneous balloon expansion comparison with open reduction and internal fixation for schatzker Ⅲ type of fracture of tibial plateau

作　　者：邱宇[1] 魏立[1] 魏祥科[1] 钟涛[1] QIU Yu;WEI Li;WEI Xiangke;ZHONG Tao(Department One of Orthopaedics, the First People′s Hospital of Yibin, Sichuan Province, Yibin 644000, China)

机构地区：[1]四川省宜宾市第一人民医院骨一科,四川宜宾644000

出　　处：《中国医药导报》2019年第3期71-74,共4页China Medical Herald

摘　　要：目的比较经皮球囊扩张术与开放复位内固定治疗SchatzkerⅢ型胫骨平台骨折的效果。方法回顾分析2010年7月～2016年7月在四川省宜宾市第一人民医院骨一科住院的62例SchatzkerⅢ型胫骨平台骨折患者的病例资料。根据不同治疗方式将其分成球囊组(23例)、内固定组(39例)。球囊组在关节镜辅助下,球囊扩张复位后骨水泥充填;内固定组在关节镜监视下,开放复位,同种异体骨植骨,锁定钢板固定。比较两组患者的手术时间、术中出血量、住院天数、总费用、并发症、术后12个月膝关节活动度及膝关节美国特种外科医院评分(HSS)。结果球囊组手术时间、术中出血量、住院天数均低于内固定组,差异有统计学意义(P <0.05);球囊组平均住院费用球囊组高于内固定组,差异有统计学意义(P <0.05);球囊组并发症发生率低于内固定组,差异有统计学意义(P <0.05)。术后12个月,球囊组患膝活动度及HSS功能评分均高于内固定组,差异有统计学意义(P <0.05)。结论膝关节镜辅助下的球囊扩张治疗SchatzkerⅢ型胫骨平台骨折手术时间及住院时间短、术中出血少、术后并发症少,且患膝可获得更好的活动度及功能,值得推广使用。Objective To compare the effect of percutaneous balloon expansion comparison with open reduction and internal fixation for schatzkerⅢ type of fracture of tibial plateau. Methods Retrospective analysis in July 2010 to July 2016 in the First People′s Hospital of Yibin City of Sichuan Province 62 cases of bone subject SchatzkerⅢ cases of patients with fracture of tibial plateau. According to different treatment methods, they were divided into balloon dilation group (23 cases) and internal fixation group (39 cases). In the balloon dilation group, with the assistance of arthroscopy, the bone cement was filled after the balloon dilation and reduction. The internal fixation group underwent open reduction, allograft and locking plate fixation under arthroscopic surveillance. The operative time, intraoperative blood loss, length of hospitalization, total cost, complications, knee mobility and knee hospital speeial surgry knee score (HSS) score at 12 months after surgery were compared between the two groups. Results The operation time, intraoperative blood loss and hospitalization daily average of the balloon dilation group were lower than those of the internal fixation group, and the differences were statistically significant (P < 0.05). The average hospitalization cost in the balloon group was higher than that in the internal fixation group, and the difference was statistically significant (P < 0.05). The incidence of complications in the balloon group was lower than that in the internal fixation group, and the difference was statistically significant (P < 0.05). Twelve months after surgery, the knee mobility and HSS function scores of the balloon group were higher than those of the internal fixation group, and the differences were statistically significant (P < 0.05). Conclusion The balloon expansion of the arthroscopic assisted treatment Schatzker Ⅲ type tibial plateau fracture operation time and shorter hospitalization time, less bleeding, fewer postoperative complications, and the risk of knee can obtain bett

关 键 词：胫骨平台骨折 SchatzkerⅢ型 球囊扩张 内固定 关节镜 

分 类 号：R687[医药卫生—骨科学]