摘要
目的比较关节镜下复位内固定与切开复位内固定治疗SchatzkerⅠ~Ⅲ型胫骨平台骨折的临床效果。方法将中山市港口医院2015年1月至2016年12月采用关节镜下复位内固定治疗的18例胫骨平台骨折患者纳入观察组,2013年1月至2014年12月行切开复位内固定的25例胫骨平台骨折患者纳入对照组,比较两组患者围手术期疗效指标和并发症、术后2 d Rasmussen胫骨平台骨折影像学评分及术后1年Rasmussen膝关节功能评分的差异。结果观察组手术时间、切口长度、术后引流量、下床活动时间均明显少于对照组(P<0.05);两组围手术期并发症发生率无明显差异(P>0.05);术后Rasmussen胫骨平台骨折影像学评分和膝关节功能评分均高于对照组,但差异无统计学意义(P>0.05);术后1年膝关节最大活动度明显高于对照组(P<0.05)。结论与切开复位内固定相比,关节镜下复位内固定治疗SchatzkerⅠ~Ⅲ型胫骨平台骨折能更好地发现和处理软组织损伤,手术创伤更小,膝关节活动度恢复更好。
Objective To compare the clinical effects of two surgical procedures of arthroscopic reduction and internal fixation（ARIF） versus open reduction and internal fixation（ORIF） for the treatment of Schatzker Ⅰto Ⅲ tibial plateau fractures. Methods Eighteen patients with tibial plateau fracture treated by ARIF from January 2015 to December 2016 in Zhongshan Gangkou Hospital were included in the observation group, and 25 patients who underwent ORIF from January 2013 to December 2014 were enrolled in the control group.Differences of perioperative therapeutic efficacy indexes and complications, Rasmussen imaging score of tibial plateau fracture 2 d postoperatively, as well as Rasmussen function evaluation score of knee joint 1 year after the surgery were compared between two groups. Results The operation time, length of the incision, postoperative drainage volume, and ambulation time in observation group were all lower than those in control group（P 〈0.05）.The difference in rate of complications between two groups had no statistical significance（P 〉0.05）.Postoperative Rasmussen imaging score and knee function evaluation score were higher in observation group,while the differences had no statistical significance between two groups（P〉 0.05）. At 1 year after the surgery, the maximum range of motion（ROM） of the knee joint in observation group was higher than that in control group（P 〈0.05）. Conclusion For the treatment of tibial plateau fracture, ARIF could help surgeons find and treat soft tissue injuries more accurately, and has the advantages of less trauma and better recovery of knee joint ROM when compared to ORIF.
作者
李锐军
林浙龙
周正茂
全守尧
汪平
蔡荣辉
LI Ruijun;LIN Zhelong;ZHOU Zhengmao;QUAN Shouyao;WANG Ping;CAI Ronghui(Department of Bone Surgery,Zhongshan Gangkou Hospital,Zhongshan,Guangdong 528400,China)
出处
《中国骨科临床与基础研究杂志》
2018年第2期101-106,共6页
Chinese Orthopaedic Journal of Clinical and Basic Research
关键词
胫骨骨折
关节镜检查
骨折固定术
内
骨折复位
外科手术
微创性
骨板
Tibial fractures
Arthroscopy
Fracture fixation,internal
Fracture reduction
Surgical procedures,minimally invasive
Bone plates
