膝关节镜辅助下闭合复位经皮螺钉内固定治疗胫骨平台骨折

Treatment of tibial plateau fracture by close reduction and transcutaneous screw fixation

目的:探讨膝关节镜辅助下闭合复位经皮螺钉内固定治疗胫骨平台骨折的临床效果。方法:将71例符合标准的胫骨平台骨折患者随机分为试验组和对照组,试验组采用膝关节镜辅助下闭合复位经皮螺钉内固定治疗,对照组采用传统手术治疗。结果:1试验组有2例Schatzker型骨折病人闭合复位失败。2试验组累计并发症显著少于对照组。3试验组膝关节临床功能优良率和复位满意率与对照组相比无统计学差异;两组放射评分值也无统计学差异;试验组临床评分高于对照组;住院时间、费用以及骨折愈合时间均少于对照组。结论:膝关节镜辅助下闭合复位经皮螺钉内固定治疗胫骨平台骨折具有安全、微创、经济、疗效好的特点,但在具体实施过程中要掌握好适应证。

Objective： To investigate the clinical effects of close reduction and internal fixing by percutaneous screw for treatment of tihial plateau fracture under arthroscope. Methods： The 71 patients with fracture of tibial plateau who meet the criterion were divided into the experimental or control group randomly. Patients of experimental group were treated with close reduction and internal fixing by percutaneous screw,the controls were treated with traditional operation. Results： （1）In the trial,there were 2 patients whose racture of tibial plateau were type of Schatzker IV failed to close reduction. （2）The total complications of the experimental group were less than that of the control group＇s . （3）Compared to the control group,there were similar rate of fine articular genual function and satisfactory fractured replacement in trial group . And their radio-scores were similar too . But the clinical scores of the trial were higher than that of the control . Length of stay,cost of hospitalization and course of fracture in trial group were all less than that of the control . Conclusion：Close reduction and internal fixing by transcutaneous screw for treatment of tibial plateau fracture under arthroscope have safe, mini-traumatic ,economic and eutherapeutic characteristics. It is worth to generalizing. But in practical applying, its suitable limit should be regulated deliberately.