摘要
目的探讨关节镜辅助下微创治疗胫骨平台骨折(SchatzkerⅠ-Ⅳ)的临床疗效。方法 2008年4月至2010年4月,在关节镜辅助下MIPPO(minimally invasive internal fixation percutaneous plate osteosynthesis)技术治疗13例胫骨平台骨折(SchatzkerⅠ-Ⅳ)。男8例,女5例;年龄18～42岁,平均32.5岁;SchatzkerⅠ型2例,Ⅱ型3例,Ⅲ型3例,Ⅳ型5例;致伤原因:运动伤2例,交通事故伤8例,坠落伤3例;合并半月板损伤3例,内侧副韧带损伤3例。受伤至手术时间为7～10d。术中在关节镜辅助下处理合并损伤、复位胫骨平台骨折,在骨折侧建立皮下骨膜外隧道,置入螺钉或LCP(locking compression plate)固定。骨折愈合后对患者膝关节功能以Lysholm评分系统评分。结果手术后切口均Ⅰ期愈合,无感染及骨筋膜室综合征等并发症发生。全部病例均获随访,平均随访25个月(12～36个月)。骨折全部愈合,平均愈合时间3.5个月(2.6～4个月)。根据Lysholm膝关节功能评分标准评定:优9例,良3例,可1例,优良率92.3%。结论关节镜辅助下微创治疗胫骨平台骨折(SchatzkerⅠ-Ⅳ),创伤小,恢复快,并发症少,可同时处理关节内合并伤,是一种可行的方法。
Objective To investigate the clinical effect of minimally invasive treatment of the tibia plateau fracture （Schatzker I -IV） by arthroscopy.Methods 13 cases with tibial plateau fractures（Schatzker I -IV） were treated underwent arthroscopy-assisted MIPPO from April 2008 to April 2010,including 8 males and 5 females aged 18-42 years old （average 32.5 years old）;There were 2 cases of typeⅠ,3 cases of typeⅡ,3 of typeⅢ,5 of typeⅣaccording to Schatzker classi？ cation system;The cause of injury involved sports injury in 2 cases,traffic injury in 8 cases,fall injury in 3cases;The fracture was combined with meniscus injury in 3 cases,and medial collateral ligament injury in 3 cases. The time from injury to operation was 7-10 days.The combined injury was treated and reduction of tibial plateau fractures was performed under arthroscopy.Then internal fixation using LCP or screws were performed after establishing subcutane- ous tunnel via minimally invasion in operation.The evaluation of keen function was taken with Lysholm score system after fracture healing.Results The wound healed by first intention in operation without complications such as infection,compartment syndrome.All the cases were followed - up with mean time 25 months（12～36 months）.No case of ununion, The mean heal time was 3.5 months（2.6～4 months）.According to Lysholm score system,9 cases were excellent results, 3 good results and 1 fair,and the excellent and good rate was 92.3%.Conclusion Owe to its features of minimal invasion,earlier recovery,fewer complications,and simultaneous treatment of associated intra-articular injuries,it is an effective method in the minimally invasive treatment of the tibial plateau fracture（SchatzkerⅠ-Ⅳ） by arthroscopy.
出处
《中国骨与关节外科》
2011年第3期209-212,共4页
Chinese Journal of Bone and Joint Surgery
关键词
胫骨骨折
关节镜
骨折内固定术
Tibial fracture
Arthroscopy
Fracture Fixation
Intramedullary
