关节镜辅助下胫骨平台骨折的微创手术治疗

Minimally invasive surgical treatment assisted by arthroscope for tibial plateau fracture

目的探讨在关节镜辅助下应用微创技术对胫骨平台骨折进行治疗的方法,评价近期疗效。方法回顾性分析2003年-2006年选择治疗的27例胫骨平台骨折,按schatzker分型,Ⅰ型8例,Ⅱ型9例,Ⅲ型7例,IV型3例。27例骨折均在关节镜辅助下进行骨折复位,经皮松质骨螺丝钉内固定或小切口支撑钢板内固定治疗。结果术后随访1～2年不等,所有骨折均在3～4个月获得骨性愈合,未出现切口愈合不良、骨关节感染、深静脉血栓形成和骨筋膜室综合征等早期并发症,2年后膝关节功能评分按meychant评分,优良26例,优良率达96.3%。结论在关节镜辅助下治疗胫骨平台骨折,可以同时处理关节内合并伤,具有创伤小、恢复快、预后好、并发症少的优点,是一种很好的治疗方法。

Objective To study the application of arthroscope-assisted minimally invasive techniques for tibial plateau fracture treatment and evaluate the recent results. Methods From January 2003 to December 2006 of 27 cases with tibial plateau fracture were analyzed retrospectively. According to schatzker type, was Type I eight cases, was Type II nine cases , was Type III seven cases, three cases was type IV. All the cases of fractures got reduction assisted by arthroscope, with the per cutem cancellous bone screw fixation or small incision support plate fixation for the treatment. Results Follow- up ranging from 1-2 years, All fractures were got bone healings after 3-4 months, there was no poor wound healing, bone and joint infections, deep vein thrombosis, bone compartment syndrome and other early complications. The knee function scores according to meychant score after 2 years, excellent was in 26 cases, the rate reached 96.3%. Conclusion The treatment assisted by arthroscope for tibial plateau fracture, not only can deal with intra-articular injuries combined with fracture but also with the advantage of less trauma, quicker recovery, better prognosis and fewer complications. So it can be consider as an excellent method of treatment.