关节镜下经皮空心螺钉内固定治疗SchatzkertⅠ~Ⅲ型胫骨平台骨折术后恢复与预后分析  

Postoperative Recovery and Prognosis Analysis of Percutaneous Cannulated Screw Fixation under Arthroscopy for Schatzker TypeⅠ~ⅢTibial Plateau Fractures

作　　者：马红红 MA Honghong(Department of Orthopedics,The First Affiliated Hospital of Nanyang Medical College,Nanyang Henan 473007,China)

机构地区：[1]南阳医学高等专科学校第一附属医院骨科,河南南阳473007

出　　处：《临床研究》2024年第9期51-54,共4页Clinical Research

摘　　要：目的分析对比关节镜下经皮空心螺钉内固定和传统切开复位内固定治疗SchatzkertⅠ~Ⅲ型胫骨平台骨折的术后恢复以及不同时间预后效果差异。方法选择2021年1月至2023年12月南阳医学高等专科学校第一附属医院收治的114例胫骨平台骨折患者,根据治疗方法分为两组,对照组55例开展传统切开复位内固定术,观察组59例开展关节镜辅助下经皮空心螺钉内固定术。比较两组患者围手术期指标、术后恢复情况,以及出院前、术后1个月和术后6个月疼痛程度、下肢功能、膝关节功能和日常生活能力水平变化。结果观察组患者术中出血量和术后引流量均明显少于对照组,差异有统计学意义(P<0.05)。观察组手术时间、下地时间、总住院时间、术后负重下地所用时间和骨折愈合时间均于对照组,差异有统计学意义(P<0.05)。出院前、术后1个月和术后6个月观察组患者视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05);两组出院前LEFS评分比较差异无统计学意义(P>0.05);术后1个月、术后6个月,观察组LEFS评分高于对照组,差异有统计学意义(P<0.05)。观察组出院前、术后1个月和术后6个月KSS评分均高于对照组,差异有统计学意义(P<0.05)。结论在关节镜辅助下开展经皮空心螺钉内固定术治疗胫骨平台骨折较传统切开复位内固定术更理想,不仅体现在前者围手术期指标更具优越性,前者术后恢复程度也相对更快,疼痛感减轻明显,并且术后运动功能和日常生活能力改善更明显。Objective To analyze and compare the postoperative recovery and prognosis at different times of percutaneous cannulated screw fixation under arthroscopy and traditional open reduction and internal fixation for Schatzker type I-III tibial plateau fractures.Methods A total of 114 patients with tibial plateau fractures treated at The First Affiliated Hospital of Nanyang Medical College from January 2021 to December 2023 were selected and divided into two groups based on the treatment method.The control group(n=55)underwent traditional open reduction and internal fixation,while the observation group(n=59)underwent percutaneous cannulated screw fixation under arthroscopy.The perioperative indicators,postoperative recovery,and changes in pain levels,lower limb function,knee joint function,and daily living ability before discharge,1 month after surgery,and 6 months after surgery were compared between the two groups.Results The intraoperative blood loss and postoperative drainage volume in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).The operation time,time to ambulation,total hospital stay,time to weight-bearing ambulation,and fracture healing time in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).Before discharge,1 month after surgery,and 6 months after surgery,the visual analog scale(VAS)scores in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in LEFS scores between the two groups before discharge(P>0.05).At 1 month and 6 months after surgery,the LEFS scores in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).The KSS scores in the observation group were higher than those in the control group before discharge,1 month after surgery,and 6 months after surgery,with statistically signif

关 键 词：胫骨平台骨折 经皮空心螺钉内固定 围手术期 疼痛 运动功能 

分 类 号：R683.4[医药卫生—骨科学]