摘要
目的分析关节镜辅助治疗Ⅴ、Ⅵ型胫骨平台骨折并前交叉韧带(ACL)撕脱骨折的临床疗效。方法回顾性选取湖北省汉川市人民医院骨外科2006年1月至2015年1月收治的经膝关节正侧位及内外斜位X线片及三维CT、MRI检查确诊的Ⅴ、Ⅵ型胫骨平台骨折合并ACL撕脱的患者共76例,排除Schatzker分型Ⅰ~Ⅵ型患者及合并病理性骨折、开放性骨折或严重血管神经损害的患者。根据手术方法分为观察组和对照组,均为38例,观察组采用关节镜下复位内固定术,对照组采用传统切开复位内固定术。用SPSS 16.0软件分析两组数据,以(±s)表示正态计量资料,采用两独立样本t检验分析两组间差异;以百分率表示计数资料,采用x^2检验分析两组间差异。对比两组患者临床疗效。结果观察组的平均手术时间长于对照组且具有统计学意义(t=3.3927,P<0.05),住院时间、骨折愈合时间和完全负重时间短于对照组(t=3.7194、t=2.9066,P<0.05),观察组术中出血量与对照组比较有统计学差异(t=9.7395,P<0.05)。观察组术后6个月的膝关节Lysholm功能评分、HSS评分和Rasmussen评分高于对照组且具有统计学意义(t=4.8714、t=2.2670、t=4.7534,P<0.05)。观察组术后6个月的总优良率为89.47%高于对照组65.79%且具有统计学意义(x^2=3.8871,P<0.05)。结论Ⅴ、Ⅵ型胫骨平台骨折并ACL撕脱采用关节镜下手术具有创伤小、术后功能恢复快、临床疗效更佳的优点。
Objective To analyze the clinical efficacy of arthroscopically assisted therapy of typeⅤand Ⅵ tibial plateau fractures with anterior cruciate ligament（ ACL） avulsion. Methods Seventy-six cases of type V and VI tibial plateau fractures combined with ACL avulsion in the orthopedic department from January 2006 to January 2015 were retrospectively selected from the People＇ s Hospital of Hanchuan,Hubei. They were divided into the arthroscopic group and the control group according to the surgical method. Schatzker type Ⅰ- Ⅵ type patients and combined pathological fracture,open fracture,or patients with severe neurovascular damage were excluded. The arthroscopic group were treated with arthroscopic fixation. The control group adopted traditional open reduction and internal fixation. Two sets of data were analysed using SPSS 16. 0 software,the normal measurement data were described as（ ± s）,two independent samples t-test was used to analyse data of the two groups; the enumeration data was described as percentage and were analyzed by x-2 test. The clinical effects were compared between the two groups.Results The average operative time of the observation group was significantly longer than that of the control group（ t = 3. 3927,P〈 0. 05）; while the length of stay,full weight bearing time and fracture healing time in the observation group were shorter than the control group（ t = 3. 7194,t = 2. 9066,P〈 0. 05）. The blood loss of the observation group was significantly less than the control group（ t = 9. 7395,P〈 0. 05）. Six months after the operation,the Lysholm score,HSS score and Rasmussen score of the observation group were significantly higher than the control group（ t = 4. 8714,t = 2. 2670,t = 4. 7534,P〈 0. 05）. Total excellent of observation group after six months was 89. 47% higher than the control group（ 65. 79%） and was statistically significant（ x-2= 3. 8871, P〈 0. 05）. Conclusion The arthroscopic surgery for type Ⅴ and Ⅵ tibial plateau fractures with ACL av
出处
《中华关节外科杂志（电子版）》
CAS
2016年第2期91-95,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
胫骨
骨折
关节镜
内固定器
Tibia
Fractures
bone
Arthroscopes
Internal fixators
