W形克氏针结合张力带钢丝内固定治疗髌骨骨折

Treatment of tibial plateau fractures with arthroscopy

目的探讨W形克氏针结合张力带钢丝内固定治疗髌骨骨折的临床疗效。方法对38例髌骨骨折患者采用髌前纵行切口,骨折复位后均行W形克氏针结合张力带钢丝内固定。结果 38例均获随访,时间8-24个月。骨折均达骨性愈合,髌骨关节面光整,无克氏针旋转、内固定物松动、断裂等并发症发生。关节功能根据Lysholm膝关节评分标准：优36例,良2例。结论 W形克氏针结合张力带钢丝内固定治疗髌骨骨折预防了改良张力带由于克氏针的旋转刺破皮肤而影响功能恢复等并发症发生。该方法操作方便,创伤小,固定牢靠,能早期活动,符合生物力学原理,临床疗效满意。

Objective To investigate the effect of the minimally invasive internal fixation with arthroscopy to treat tibial plateau fracture.Methods The clinical data of 42 cases of closed tibial plateau fractures were analysed retrospectively.All cases were examined and reduced under arthroscopy,and treated by minimally invasive internal fixation.Results All cases were followed up for 14～32 months.All fractures were unitied after 4～9 postoperative months,and no infection or ankylosis occurred.The X-ray findings showed 37 cases got anatomic reduction,5 cases got collapse fracture of tibial poateau within 2mm.According to Rasmussen′s knee rating system,27 cases had excellent results,11 good,and 4 fair.The excellent and good rate was 90.5%.Conclusions It is good way to treat tibial fracture with arthroscopy,which requires minimal trauma and provides quick recovery.