关节镜辅助MIPPO技术治疗老年Schatzker Ⅱ~Ⅲ型胫骨平台骨折的疗效及预后研究  

Efficacy and prognosis of arthroscopic-assisted MIPPO technique in the treatment of elderly Schatzker Ⅱ-Ⅲ tibial plateau fractures

作　　者：葛新江 游建军[1] 刘晓峰[1] 马英[1] Ge Xinjiang;You Jianjun;Liu Xiaofeng;Ma Ying(First People's Hospital of Aksu Prefecture,Aksu 843000,Xinjiang Province,China)

机构地区：[1]新疆阿克苏地区第一人民医院,新疆阿克苏843000

出　　处：《中国临床解剖学杂志》2021年第3期342-345,350,共5页Chinese Journal of Clinical Anatomy

基　　金：2017年度阿克苏地区人才项目(阿地党组传[2017]217号-【12】)。

摘　　要：目的分析关节镜辅助微创经皮钢板接骨术(minimal y invasive percutaneous plate osteosynthesis,MIPPO)治疗老年Schatzker Ⅱ~Ⅲ型胫骨平台骨折的疗效及预后。方法选取本院老年Schatzker Ⅱ~Ⅲ型胫骨平台骨折患者43例,按手术方式分为观察组(关节镜辅助MIPPO,19例)和对照组(切开复位内固定术,24例),比较两组术后近期疗效、近远期并发症及远期生活质量差异。结果观察组较对照组,切口长度、住院时间、骨愈合时间均显著缩短,术中出血量、术后引流量均显著减少,均P<0.05。观察组较对照组,切口感染、皮肤坏死率、延迟愈合、关节僵硬及创伤性关节炎等术后并发症比率显著降低,均P<0.05。观察组术后Rasmussen功能及放射学评分优良率均显著高于对照组,均P<0.05。两组患者治疗后生活质量各项评分均显著高于治疗前,均P<0.05。结论关节镜辅助MIPPO技术治疗老年Schatzker Ⅱ~Ⅲ型胫骨平台骨折,创伤及近、远期并发症有效降低,恢复显著加快,生活质量显著提高。Objective To analyze the efficacy and prognosis of arthroscopy-assisted minimally invasive percutaneous plate osteosynthesis(MIPPO)technology in the treatment of elderly Schatzker type Ⅱ-Ⅲ tibial plateau fractures.Methods Forty-three patients with Schatzker type Ⅱ-Ⅲ tibial plateau fracture in our hospital were divided into an observation group(arthroscopy-assisted MIPPO technique,19 cases)and a control group(traditional incision and reduction and internal fixation,24 cases)according to the surgical method.The short-term effects after operation,short-term complications,and long-term quality of life in two groups were compared.Results Compared with the control group,the incision length,length of hospital stay,and bone healing time of the observation group were much shorter,the intraoperative blood loss and postoperative drainage volume significantly reduced(all P<0.05).The rates of incision infection,skin necrosis,delayed healing,joint stiffness,and traumatic arthritis of the observation group were much lower than those of the control group(all P<0.05).The Rasmussen function and radiological scores of the observation group were much higher than those of the control group(all P<0.05).The scores of the two groups of patients after treatment were significantly higher than those before the treatment(both P<0.05).Conclusions Arthroscopy-assisted MIPPO technique for the treatment of elderly Schatzker type Ⅱ-Ⅲ tibial plateau fractures effectively reduces trauma and near-term complications,significantly accelerates recovery,and significantly improves quality of life.

关 键 词：胫骨平台骨折 经皮接骨板内固定 关节镜 MIPPO技术 预后 

分 类 号：R683.42[医药卫生—骨科学]