镜下经皮空心螺钉联合不同时机跨关节外固定对SchatzkerⅤ~Ⅵ型胫骨平台骨折的效果分析  

Analysis of the Effects of Arthroscopic-Assisted Percutaneous Hollow Screws Combined with Cross-Joint External Fixation at Different Times on Schatzker TypeⅤ-ⅥTibial Plateau Fractures

作　　者：马红红 MA Honghong(Department of Orthopedics,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》2025年第4期61-64,共4页Clinical Research

摘　　要：目的分析在镜下经皮空心螺钉联合不同时机跨关节外固定对SchatzkerⅤ~Ⅵ型胫骨平台骨折的疗效,为临床提供参考。方法选取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112例SchatzkerⅤ型~Ⅵ型胫骨平台骨折患者为研究对象。按照随机数字表法分为对照组和观察组,各56例。对照组患者在骨折发生后24~72 h内接受跨关节外固定支架治疗,观察组患者在骨折发生后24 h内接受跨关节外固定支架治疗。两组患者在第一阶段的跨关节外固定支架植入术后接受相应的治疗措施,直至软组织损伤有明显好转,随后进入第二阶段,两组患者均接受关节镜辅助下的经皮空心螺钉内固定术。比较两组患者治疗效果、手术相关指标、疼痛因子(P物质、前列腺素E2、缓激肽)和炎症因子(肿瘤坏死因子-α、白细胞介素-1β、基质金属蛋白酶-3)水平。结果观察组患者优良率高于对照组,差异有统计学意义(P<0.05)。观察组患者Ⅰ期术后水疱发生率和Ⅰ期术后肿胀程度低于对照组,入院至Ⅱ期手术时间、总住院时长、骨折愈合时间均短于对照组,差异有统计学意义(P<0.05)。术后第7天,两组患者的P物质、前列腺素E2、缓激肽水平降低,且观察组更低,差异有统计学意义(P<0.05)。术后第7天,两组患者的肿瘤坏死因子-α、白细胞介素-1β、基质金属蛋白酶-3水平降低,且观察组更低,差异有统计学意义(P<0.05)。结论在治疗SchatzkerⅤ~Ⅵ型胫骨平台骨折时,早期应用跨关节外固定支架技术,可以显著减少邻近软组织的损伤程度,增强临床疗效,同时减轻患者的痛感和炎症反应,值得临床广泛应用。Objective To analyze the efficacy of arthroscopic-assisted percutaneous hollow screws combined with cross-joint external fixation at different times on Schatzker TypeⅤ-Ⅵtibial plateau fractures,providing a reference for clinical practice.Methods A total of 112 patients with Schatzker TypeⅤ-Ⅵtibial plateau fractures treated at the First Affiliated Hospital of Nanyang Medical College from January 2021 to December 2023 were selected as the study subjects.They were randomly divided into a control group and an observation group,with 56 cases in each group.Patients in the control group received cross-joint external fixation brace treatment within 24~72 hours of fracture occurrence,while patients in the observation group received treatment within 24 hours.Both groups underwent corresponding treatment measures after the implantation of the external fixation brace during the initial phase until significant improvement of soft tissue damage was observed.They then proceeded to the second phase,during which both groups received arthroscopic-assisted percutaneous hollow screw internal fixation.The therapeutic effects,surgical-related indicators,pain factors(substance P,prostaglandin E2,bradykinin),and inflammatory factors(tumor necrosis factor-alpha,interleukin-1β,matrix metalloproteinase-3)were compared between the two groups.Results The excellent rate in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).The occurrence rate of blisters and the degree of swelling postoperatively after stage I were lower in the observation group than in the control group.The time from admission to stage II surgery,total length of hospitalization,and fracture healing time were shorter in the observation group than in the control group,with statistically significant differences(P<0.05).On postoperative day 7,levels of substance P,prostaglandin E2,and bradykinin decreased in both groups,with the observation group showing lower levels,and the difference was statistically si

关 键 词：镜下经皮空心螺钉 跨关节 外固定 胫骨平台骨折 肿胀 

分 类 号：R683.4[医药卫生—骨科学]