关节镜监视下经皮锁定钢板内固定治疗胫骨平台骨骨折

Tibial Plateau Fractures Treated with Arthroscopy-assisted Operative Management and Locked by Locking Compression Plate

目的:探讨在关节镜监视下使用锁定钢板内(locking compression plate,LCP)治疗胫骨平台骨折的临床效果。方法:自2007年6月-2010年3月对31例胫骨平台骨折在关节镜监视下进行复位,塌陷处以异体骨植骨,并以LCP钢板固定。结果:本组骨折均愈合,随访7～27个月,平均16个月。根据国际HSS膝功能制定的标准:优22例(85～100分),占71%;良7例(70～84分),占22.6%;一般2例(60～69分),占6.4%;差0例(60分以下)。优良率为93.5%。结论:对于胫骨平台骨折的治疗,LCP钢板固定治疗,手术创伤小,术后并发症少,可提供足够稳定性,减少术后复位丢失。辅助关节镜以后可以使关节内复位更加精确,术中对复位判断更为准确,降低术后畸形愈合率,是胫骨平台骨折手术的较理想方法。

Objective.To discuss the clinical outcomes of tibial plateau fractures treated with arthroscopy-assisted operative management and locked by LCP. Methods.From June 2007 to March 2010,31 patients with tibial plateau fractures were reduced with arthroscopy-assisted and treated by LCP and bone defects were filled with homogene ousallograft bone. Results.With follow-up visits for 7 - 27 months, all cases were healed. According to criteria of HSS excellent were in 22 cases,good in 7 cases, fair in 2 case,with the rate of being excellent and good added up to 93. 5%. Con- dusion：LCP fixation is an effective technique for the low-energy tibial plateau fractures treatment with the advantage of less invasion, steadier fixation and lower complication rate. Arthroscopy-assisted operative management can help to reduce reduction loss from intra-articular more precisely to reach a higher union rate. It is also a preferable method for low-energy tibial plateau fractures treatment.