摘要
背景:SchatzkerⅡ~Ⅲ型是常见的胫骨平台骨折类型,而关于关节镜辅助经皮接骨板内固定(minimally invasive percutaneous plate osteosynthesis,MIPPO)技术疗效评估的前瞻性研究较少。目的:评估关节镜辅助MIPPO技术应用于SchatzkerⅡ~Ⅲ型胫骨平台骨折治疗的疗效及对患者远期生活质量的影响。方法:选取我院2014年4月至2016年3月收治的81例SchatzkerⅡ~Ⅲ型胫骨平台骨折患者,随机分为实验组与对照组,实验组患者接受关节镜辅助MIPPO技术治疗,对照组患者采用传统切开复位内固定术治疗。收集并分析患者手术时间、术中总出血量、切口长度、术后总引流量、术后患者住院时间、切口愈合及骨愈合时间,术后30 d内切口感染、关节感染及皮肤坏死等近期并发症发生情况,延迟愈合、关节僵硬及创伤性关节炎等远期术后并发症发生情况的数据。采用Rasmussen功能评分及放射学评分评估膝关节功能恢复状况;术前与术后12个月均采用SF-36健康调查简表评估两组患者生活质量。结果:与对照组比较,实验组切口长度缩短,术中总出血量与术后总引流量均减少,术后患者住院时间、切口及骨愈合时间缩短;实验组术后近期并发症(切口感染、皮肤坏死及关节感染)发生率(26.8%vs 5.0%)、远期术后并发症(延迟愈合、创伤性关节炎及关节僵硬)发生率(26.8%vs 7.5%)均减少(P<0.05)。实验组术后膝关节功能恢复疗效和远期患者生活质量均高于对照组(P<0.05)。结论:关节镜辅助MIPPO技术治疗SchatzkerⅡ~Ⅲ型胫骨平台骨折具有手术损伤小、疗效确切、患者恢复快,低并发症发生率等优势,并能够有助于患者膝关节功能恢复和提高生活质量。
Background： Schatzker Ⅱ-Ⅲ are common clinical types of tibial plateau fracture. By far, there is lack of the prospective study about utilizing minimally invasive percutaneous plate osteosynthesis（MIPPO） technique to cure above types of tibial plateau fracture. Objective： To evaluate the effect of MIPPO assisted with arthroscopy on Schatzker Ⅱ-Ⅲ types of tibial plateau fracture and long term life quality of patients. Methods： A total of 81 patients with Schatzker Ⅱ-Ⅲ types of tibial plateau fracture treated in our hospital between April 2014 and March 2016 were selected and divided into experimental group（MIPPO technique） and control group（traditional surgery） randomly. The data including operation duration, intraoperative blood loss, length of incision, volume of postoperative drainage, time of postoperative stay, healing time of incision and fracture, early postoperative complications such as incision infection, joint infection and skin necrosis occurring with 30 days after operation and late postoperative complications such as bone delayed union, anchylosis and traumatic osteoarthritis were collected and analyzed. The Rasmussen＇s knee function score and radiological index were utilized to assess the function recovery of knee joint. The short form 36（SF 36） health survey was employed to evaluate the life quality of the patients in the two groups at both preoperation and 12 months after operation. Results： The data of length of incision, intraoperative blood loss, volume of postoperative drainage, time of postoperative hospital stay, healing time of incision and fracture in experimental group were all less than that in control group. The total occurrences of early postoperative complications（5.0% vs 26.8%） and late postoperative complications（7.5% vs 26.8%） were lower in experiment group than in control group（P〈0.05）. In the experimental group, the function recovery of knee joint and long term life quality of the patients were significantly higher than that in t
出处
《中华骨与关节外科杂志》
2017年第5期428-432,共5页
Chinese Journal of Bone and Joint Surgery
关键词
胫骨平台骨折
关节镜
经皮接骨板内固定
生活质量
Tibial Plateau Fracture
Arthroscopy
Minimally Invasive Percutaneous Plate Osteosynthesis
Life Quality
