关节镜辅助与切开复位钢板内固定治疗SchatzkerⅠ~Ⅴ型胫骨平台骨折的比较  

Comparison of Arthroscopy-assisted Reduction and Conventional Open Reduction Fixation With Plate for SchatzkerⅠ-ⅤTibial Plateau Fractures

作　　者：翟生[1] 黄涛[1] Zhai Sheng;Huang Tao(Department of Orthopedics,Fifth Affiliated Hospital of Xinjiang Medical University,Urimqi 830011,China)

机构地区：[1]新疆医科大学第五附属医院骨一科,乌鲁木齐830011

出　　处：《中国微创外科杂志》2020年第10期901-905,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨关节镜辅助切开复位钢板内固定的优势及缺陷。方法回顾性分析2015年3月~2018年3月52例随访资料完整的钢板内固定治疗SchatzkerⅠ~Ⅴ型胫骨平台骨折的临床资料,其中关节镜辅助复位25例,切开复位27例,比较2组手术指标、术后早期并发症发生率及术后1年美国特种外科医院(Hospital for Special Surgery,HSS)膝关节功能评分。结果2组手术时间及早期并发症发生率差异无显著性(P>0.05),但在术后血红蛋白降低及1年膝关节功能评分上,关节镜辅助复位优于切开复位[(21.6±4.0)g/L vs.(26.6±6.0)g/L,t=-3.553,P=0.001;(81.6±9.4)分vs.(74.2±11.9)分,t=2.460,P=0.017]。结论与传统切开复位钢板内固定相比,关节镜辅助复位治疗SchatzkerⅠ~Ⅴ型胫骨平台骨折疗效较好,具有手术失血量少及关节功能恢复好等优点。Objective To explore the advantages and disadvantages of arthroscopy-assisted therapy by comparison of therapeutic effects between arthroscopic assisted reduction and traditional open reduction with plate internal fixation in the treatment of SchatzkerⅠ-Ⅴtibial plateau fractures.Methods Fifty-two patients with SchatzkerⅠ-Ⅴtibial plateau fractures with complete follow-up data from March 2015 to March 2018 were analyzed retrospectively,including 27 patients treated by traditional open reduction fixation with plate and 25 patients treated by arthroscopy-assisted reduction fixation with plate.The operation data,incidence of early postoperative complications and knee joint function score of Hospital for Special Surgery(HSS)at one year follow-up were compared between the two groups.Results There was no significant difference in the operation time and the incidence of early postoperative complications between the two groups(P>0.05).However,arthroscopic assisted reduction was superior to traditional open reduction in terms of decreased hemoglobin level on the first day after operation and HSS knee joint function score at one year follow-up[(21.6±4.0)g/L vs.(26.6±6.0)g/L,t=-3.553,P=0.001;(81.6±9.4)points vs.(74.2±11.9)points,t=2.460,P=0.017].Conclusion Compared with traditional open reduction,arthroscopic assisted reduction fixation with plate has more satisfactory surgical effects in the treatment of SchatzkerⅠ-Ⅴtibial plateau fractures.

关 键 词：胫骨平台骨折 关节镜 

分 类 号：R68[医药卫生—骨科学]