ARIF和ORIF治疗SchatzkerⅠ~Ⅲ型胫骨平台骨折疗效对比分析  

Comparison of Clinical Efficacy of ARIF and ORIF in the Treatment of Tibial Plateau Fracture of Schatzker TypeⅠ-Ⅲ

作　　者：杨俊峰 袁庆杰 乔顺风 YANG Junfeng;YUAN Qingjie;QIAO Shunfeng(Department of Orthopedics,Linzhou Renji Hospital,Anyang,Henan 455000,China;Surgery Department,The Affiliated Hospital of Hebei Engineering University Hezhong Branch,Handan,Hebei 056000,China;Department of Orthopedics,Handan Hand Surgery Hospital,Handan,Hebei 056000,China)

机构地区：[1]林州仁济医院骨科,河南安阳455000 [2]河北工程大学附属医院和中院区外科,河北邯郸056000 [3]邯郸手外医院骨科,河北邯郸056000

出　　处：《中国烧伤创疡杂志》2023年第5期404-407,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的对比分析关节镜辅助复位内固定(ARIF)和切开复位内固定(ORIF)治疗SchatzkerⅠ~Ⅲ型胫骨平台骨折的临床疗效。方法选取2018年10月至2020年10月林州仁济医院-河北工程大学附属医院和中院区-邯郸手外医院共3家医院收治的80例SchatzkerⅠ~Ⅲ型胫骨平台骨折患者作为研究对象,按照不同治疗方法将其分为ARIF组(42例)和ORIF组(38例),ARIF组患者行ARIF治疗,ORIF组患者行ORIF治疗,对比观察两组患者手术时间-术中出血量-切口愈合时间-骨折愈合时间-膝关节功能以及术后并发症发生情况。结果ARIF组患者手术时间明显长于ORIF组(t=3.363,P=0.001),术中出血量与ORIF组无明显差异(t=1.235,P=0.220),切口愈合时间及骨折愈合时间均明显短于ORIF组(t=3.657-3.607,P=0.001-0.001)。术后随访12个月,ARIF组患者膝关节功能恢复优良率为92.86%,明显高于ORIF组患者的膝关节功能恢复优良率76.32%(χ^(2)=4.281,P=0.039);ARIF组患者术后并发症发生率为4.76%,与ORIF组患者的术后并发症发生率10.53%无明显差异(χ^(2)=0.956,P=0.328)。结论与ORIF相比,ARIF更有利于加快SchatzkerⅠ~Ⅲ型胫骨平台骨折的愈合,提高膝关节功能恢复效果,疗效更显著。Objective To compare the clinical efficacy of arthroscopically-assisted reduction and internal fixation(ARIF)and open reduction and internal fixation(ORIF)in the treatment of tibial plateau fracture of Schatzker typeⅠ-Ⅲ.Methods 80 patients with tibial plateau fracture of Schatzker typeⅠ-Ⅲadmitted into three hospitals-Linzhou Renji Hospital,The Affiliated Hospital of Hebei Engineering University Hezhong Branch and Handan Hand Surgery Hospital between October 2018 and October 2020 were enrolled as research subjects,and divided into ARIF group(n=42)and ORIF group(n=38)based on different treatments they received.Patients in the ARIF group were treated with the ARIF,while patients were treated with the ORIF in the ORIF group.The operation time,intraoperative blood loss,incision healingtime,fracture healing time,knee functions and occurrence of postoperative complications of patients were compared between the two groups.Results The operation time of patients in the ARIF group was obviously longer than that in the ORIF group(t=3.363,P=0.001),the incision healing time and fracture healing time of patients were significantly shorter in the ARIF group(t=3.657 and 3.607,P=0.001 and 0.001),and there was no statistically significant difference between the two groups in terms of intraoperative blood loss(t=1.235,P=0.220).During the follow-up 12 months after surgery,the excellent and good rate of knee functional recovery of patients was 92.86%in the ARIF group,being markedly higher than the corresponding 76.32%in the ORIF group(χ^(2)=4.281,P=0.039).The incidence of postoperative complications was 4.76%in the ARIF group,which showed no statistically significant difference compared with the corresponding 10.53%in the ORIF group(χ^(2)=0.956,P=0.328).Conclusion Compared with ORIF,the ARIF is more favorable for fast healing of tibial plateau fracture of Schatzker typeⅠ-Ⅲ,and improving the functional recovery of knee joint,and the clinical efficacy is definite.

关 键 词：关节镜辅助复位内固定 切开复位内固定 胫骨平台骨折 SCHATZKER分型 膝关节功能 

分 类 号：R687.3[医药卫生—骨科学]