关节镜技术微创治疗SchatzkerⅠ～Ⅳ型胫骨平台骨折

Arthrocopical internal fixation in treatment of SchatzkerⅠ-Ⅳtype tibial plateau fractures

目的研究关节镜技术在SchatzkerⅠ～Ⅳ型胫骨平台骨折治疗中的应用价值。方法2001年3月～2006年2月，对24例SchatzkerⅠ～Ⅳ型（Ⅰ型8例，Ⅱ型7例，Ⅲ型5例，Ⅳ型4例）胫骨平台骨折在关节镜监护下进行小切口复位螺钉内固定术，镜下同时处理关节内合并损伤，术后随访患者并发症，并用HSS膝关节评分标准进行膝关节功能评分。结果术后随访5～17个月，所有骨折均在3个月内愈合，无感染、皮肤坏死或创口延迟愈合。按相关标准评定疗效，总优良率91．7％。结论关节镜监护下治疗胫骨平台骨折损伤小，操作安全，复位固定满意，能同时处理关节内合并伤，术后功能恢复快。

Objective To evaluate arthrocopic technique in the treatment of Schatzker Ⅰ～Ⅳ type tibial plateau fractures. Methods From March 2001 to February 2006, 24 cases of tibial plateau fractures were treated with reduction and screw fixation assisted arthroscopically. According to Schatzker classification , there were 8 cases in type Ⅰ ,7 in Ⅱ , 5 in Ⅲ and 5 in Ⅳ. The associated intra-articular pathology were treated simultaneously. Complications and function recovery were investigated. Results All the cases were followed up for 5-17months. All fractures healed within three months,and no infection,skin necrosis or wound delayed union happened. The rate of excellent and good was 91.7 % according to HSS evaluation criterion. Conclusion The reduction and fixation with assistance of arthroscope for the tibial plateau fracture has the advantages of minimal injury ,safe operation, accurate reduction and fixation ,early recovery and convenient management for the associated intra-articular pathology at the same time.