微创经皮钢板内固定治疗SchatzkerⅥ型胫骨平台骨折的前瞻性研究

Treatment of Schatzker VI fractures of tibial plateau by minimally invasive plate osteosynthesis： a prospective randomized comparison

目的对比研究微创经皮钢板内固定（MIPPO）和传统钢板内固定治疗SchatzkerⅥ型胫骨平台骨折的临床疗效。方法采用前瞻性研究将2000年3月～2004年12月期间诊治的34例SchatzkerⅥ型胫骨平台骨折患者随机分为MIPPO治疗组（17例）和传统钢板内固定治疗组（17例）。比较两组病例疗效的差异。结果MIPPO治疗组的手术耗时、手术失血量和并发症较传统钢板内固定治疗组显著减少（P〈0．05），骨折愈合更快（P〈0．05）和膝关节功能恢复更满意（P〈0．05），患者对疗效更满意（P〈0．05）。结论小切口直视治疗关节内损伤结合经皮治疗其他骨折部位的MIP-PO可解剖复位关节内骨折，尽可能地保留了软组织的完整性，降低了软组织的手术损伤，减少了感染等并发症的发生，有利于软组织、骨折愈合和膝关节功能的恢复，是治疗SchatzkerⅥ型胫骨平台骨折的一种理想方法。

Objective To investigate prospectively the clinical curative effects of minimally invasive plate osteosynthesis （MIPPO） and orthodox steel plate internal fixation in the treatment of Schatzker Ⅵ fractures of tibial plateau. Methods Thirty-four cases of Schatzker VI fractures of tibial plateau who sought treatment in our department from March 2000 to December 2004 were randomly assigned to group A （MIPPO, 17 cases） and group B （orthodox steel plate internal fixation, 17 cases）. The curative effects of the 2 treatments were compared. Results Compared with group B, the operation time, blood loss and complications were markedly less （P〈0.05）, fractures healed faster, knee function recovered better, and curative effects were more satisfactory （P〈0.05） in group A. Conclusion Since the MIPPO with euthyphoria can reestablish the intra-articular anatomy, retain soft tissue integrity, reduce soft tissue invasion, decrease infections and complications, and promote soft tissue and fracture healing and articular functional rehabilitation, it is a good way of treating Schatzker IV fractures of tibial plateau.