关节镜联合微创钢板接骨术治疗胫骨平台骨折伴交叉韧带损伤的临床观察  

Observe on the clinical effect of arthroscopy combined with minimally invasive steel plate osteosynthesis for the treatment of tibial plateau fractures with cruciate ligament injury

作　　者：李敬[1] LI Jing(The First Affiliated Hospital of Wenzhou Medical University,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第一医院,温州325000

出　　处：《浙江创伤外科》2023年第10期1822-1825,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的 探讨关节镜联合微创钢板接骨术(MIPPO)用于治疗胫骨平台骨折(TPF)合并前交叉韧带损伤(ACL)的临床效果。方法 以50例TPF合并ACL患者为研究对象,分为对照组(25例)和研究组(25例),对照组进行切开复位内固定术治疗,研究组实施关节镜联合MIPPO治疗,记录患者手术指标情况,测定膝关节功能恢复情况,评价疗效水平,检测术后血流变学指标变化,观察术后并发症情况。结果研究组术中出血量、住院时间和骨折愈合时间均显著短于对照组(P<0.05);研究组术后7 d血流变学指标均较对照组水平显著改善(P<0.05);研究组术后6个月HSS评分和Rasmussen膝关节功能评分均显著高于对照组水平(P<0.05);研究组术后6个月临床疗效总体优良率(96.00%)显著高于对照组水平(76.00%)(P<0.05);研究组术后并发症总体发生率(0.00%)显著低于对照组水平(20.00%)(P<0.05)。结论 关节镜联合MIPPO治疗TPF合并ACL,可有效减低手术医源性创伤,加快术后康复,改善血流变学指标,提高膝关节功能恢复及临床疗效水平,降低术后并发症发生风险。Objective To explore the clinical effect of arthroscopy combined with minimally invasive plate osteosynthesis(MIPPO) for the treatment of tibial plateau fractures(TPF) combined with anterior cruciate ligament injury(ACL).Methods 50 patients with TPF combined with ACL were divided into a control group(25 cases) and a study group(25 cases).The control group received open reduction and internal fixation surgery,while the study group received arthroscopy combined with MIPPO treatment.The operation indexes were recorded,the postoperative knee function recovery and clinical efficacy were evaluated,the changes of postoperative hemorheological indexes were detected,and the postoperative complications were observed.Results The amount of intraoperative bleeding,hospital stay and fracture healing time in the study group were shorter than those in the control group(P<0.05).The hemorheological indexes in the study group were improved compared with the control group 7 days after operation(P<0.05).The HSS score and Rasmussen knee function score in the study group were higher than those in the control group 6 months after operation(P<0.05).The overall excellent and good rate of clinical efficacy 6 months after operation in the study group(96.00%) was higher than that in the control group(76.00%)(P<0.05).The overall incidence of postoperative complications in the study group(0.00%) was lower than that in the control group(20.00%)(P<0.05).Conclusion Arthroscopy combined with MIPPO for the treatment of TPF combined with ACL can effectively re-duce iatrogenic trauma,accelerate postoperative recovery,improve hemorheological indicators,improve knee joint function recovery and clinical effica-cy,and reduce the risk of postoperative complications.

关 键 词：关节镜 微创钢板接骨术 胫骨平台骨折 前交叉韧带损伤 膝关节功能 术后并发症 

分 类 号：R687.3[医药卫生—骨科学]