摘要
目的探讨关节镜辅助下内固定治疗胫骨平台骨折的疗效。方法将78例胫骨平台骨折患者按照术式不同分为观察组(采用关节镜辅助下内固定治疗,40例)和对照组(采用传统切开复位内固定治疗,38例)。比较两组骨折复位质量、骨痂形成时间、骨折愈合时间、下床活动时间、开始部分负重时间、膝关节活动度、行走情况及并发症发生情况。采用HSS评分评价膝关节功能。结果患者均获得随访,时间3~6个月。骨痂形成时间、下床活动时间、开始部分负重时间观察组明显早于对照组(P<0.01);骨折愈合时间两组比较差异无统计学意义(P>0.05)。术后1、3个月膝关节HSS评分观察组均明显高于对照组(P<0.01);术后3个月膝关节活动度观察组优于对照组(P<0.05)。术后并发症发生率观察组低于对照组(P<0.05)。末次随访时,骨折复位质量及功能改善优良率观察组高于对照组(P<0.05);患者完全负重行走率观察组高于对照组(P<0.05)。结论关节镜辅助下内固定治疗胫骨平台骨折能有效提高骨折复位质量,恢复膝关节活动度,改善膝关节功能,减少并发症的发生。
Objective To investigate the effect of arthroscopic assisted internal fixation on the tibial plateau fracture.Methods The 78 patients with tibial plateau fractures were divided into observation group(40 cases were treated with arthroscopic assisted internal fixation)and control group(38 cases were treated with traditional open reduction internal fixation).The quality of fracture reduction,the time of callus formation,fracture healing,the time of getting out of bed,the time to start partial weight-bearing,the range of motion of knee joint,walking condition and the incidence of complications were compared between the two groups.The knee joint function was evaluated by HSS score.Results All patients were followed up for 3~6 months.The time of callus formation,the time of getting out of bed and the time to start partial loading in the observation group were significantly earlier than those in the control group(P<0.01).The fracture healing time had no statistical difference between the two groups(P>0.05).At 1,3 months after surgery,the knee HSS score of observation group was significantly higher than that of control group(P<0.01).The knee motion of the observation group was better than that of the control group at 3 months after operation(P<0.05).The incidence rate of postoperative complications in observation group was lower than that in the control group(P<0.05).At the last follow-up,the excellent and good rate of fracture reduction quality and functional improvement in the observation group were higher than those in the control group(P<0.05);the rate of walking with full weight-bearing of patients in the observation group was higher than that in the control group(P<0.05).Conclusions Endoscopic assisted internal fixation in the treatment of tibial plateau fracture can effectively improve the quality of fracture reduction,restore the range of motion of the knee joint,improve the function of the knee joint and reduce the incidence of complications.
作者
谭长龙
赵金柱
曲良
李鹏
陶春生
TAN Chang-long;ZHAO Jin-zhu;QU Liang;LI Peng;TAO Chun-sheng(Dept of Orthopaedics,the 971st Hospital of CPLA Navy,Qingdao,Shandong 266000,China)
出处
《临床骨科杂志》
2023年第6期866-870,共5页
Journal of Clinical Orthopaedics
关键词
胫骨平台骨折
切开复位
关节镜检查
内固定术
膝关节活动度
膝关节功能
tibial plateau fractures
open reduction
arthroscopy
internal fixation
knee range of motion
knee joint function
