关节镜监视下经皮锁定钢板内固定治疗SchatzkerⅡ~Ⅲ型胫骨平台骨折疗效观察  

Therapeutic effect of internal fixation with percutaneous locking plate under arthroscopic monitoring for the treatment of SchatzkerⅡ-Ⅲtibial plateau fracture

作　　者：刘兵 马翔宇 宋夏楠 刘欣伟 周大鹏 LIU Bing;MA Xiang-yu;SONG Xia-nan;LIU Xin-wei;ZHOU Da-peng(Department of Orthopaedics,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院骨科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2020年第5期356-360,共5页Trauma and Critical Care Medicine

摘　　要：目的探讨关节镜监视下经皮锁定钢板内固定治疗SchatzkerⅡ~Ⅲ型胫骨平台骨折的临床疗效。方法选取北部战区总医院自2015年7月至2018年7月收治的68例SchatzkerⅡ~Ⅲ型胫骨平台骨折患者为研究对象。将患者随机分为传统治疗组和联合治疗组,每组各34例。传统治疗组给予传统切开复位锁定钢板内固定治疗,联合治疗组采用关节镜监视下辅助复位,经皮微创锁定钢板内固定治疗,比较两组患者的手术相关指标、临床疗效及并发症的发生情况等。结果两组患者的手术时间、骨折愈合时间比较,差异均无统计学意义(P>0.05);联合治疗组患者的切口长度、住院时间均短于传统治疗组,术中失血量少于传统治疗组,差异均有统计学意义(P<0.05)。联合治疗组患者术后膝关节功能恢复的优良率为94.1%(32/34),明显高于常规治疗组的70.6%(24/34),差异有统计学意义(P<0.05)。联合治疗组患者的并发症发生率为14.7%(5/34),明显低于传统治疗组的38.2%(13/34),差异有统计学意义(P<0.05)。结论关节镜监视下经皮锁定钢板内固定治疗SchatzkerⅡ~Ⅲ型胫骨平台骨折的临床效果显著,具有手术创伤小,术中失血少,住院时间短,膝关节功能恢复优良率高,术后并发症少等特点。Objective To investigate the therapeutic effect of percutaneous locking plate internal fixation under arthroscopic monitoring for the treatment of SchatzkerⅡ-Ⅲtibial plateau fracture.Methods A retrospective study was performed on 68 cases of patients with SchatzkerⅡ-Ⅲtibial plateau fracture who were admitted from July 2015 to July 2018.Patients were randomly divided into the conventional treatment group and the combined treatment group,with 34 cases in each group.The conventional treatment group of patients were treated with traditional open reduction and locking plate internal fixation.The combined treatment group of patients were treated with arthroscopic assisted reduction and percutaneous minimally invasive locking plate internal fixation.The operative indicators,clinical efficacy and complications were compared between the two groups.Results There was no statistically significant difference between the two groups in operation time and fracture healing time(P>0.05).The incision length and length of hospital stay in the combined treatment group were shorter than those in the traditional treatment group,and the intraoperative blood loss was less than that in the traditional treatment group,with statistically significant differences(P<0.05).The excellent and good rate of knee functional recovery after operation in the combined treatment group was 94.1%(32/34),which was significantly higher than that in the conventional treatment group(70.6%,24/34),P<0.05.The complication rate of the combined treatment group was 14.7%(5/34),significantly lower than that of the traditional treatment group(38.2%,13/34),P<0.05.Conclusion Percutaneous locking plate internal fixation under arthroscopy monitoring treatment SchatzkerⅡ-Ⅲtibial plateau fracture clinical effect is remarkable,with a small surgical trauma,less intraoperative blood loss,shorter hospitalization time,knee joint functional recovery is high,less postoperative complications.

关 键 词：关节镜 胫骨平台骨折 微创 内固定 

分 类 号：R687[医药卫生—骨科学]