关节镜技术对胫骨平台骨折患者膝关节功能恢复的影响

The Clinical Effect of Arthroscopy on Knee Joint Function Recovery of Patients with Tibial Plateau Fractures

目的观察关节镜技术在胫骨平台骨折患者术中应用后对患者膝关节功能恢复的影响。方法将2008年1月～2011年1月收治的63例胫骨平台骨折患者(Schatzber分型Ⅰ～Ⅳ型)作为研究对象,其中30例患者单纯行骨折切开复位内固定术,33例术中常规行关节镜下检查、清理,并于关节镜监视下行骨折复位内固定。所有患者于术后3、6、12个月随访,术后膝关节功能恢复程度参考Rasmussen膝关节功能评分标准进行评定。结果术后3个月随访,单纯手术治疗组膝关节功能评分10～24分,平均(15.8±3.2)分,关节镜组膝关节功能评分12～25分,平均(18.8±3.0)分。两组膝关节功有明显统计学差异(P<0.05),关节镜组优于单纯手术组。术后6个月随访,单纯手术治疗组膝关节功能评分10～28分,平均(23.5±3.4)分,关节镜组膝关节功能评分12～29分,平均(25.8±3.2)分。两组膝关节功有明显统计学差异(P<0.05),关节镜组优于单纯手术组。术后12个月随访,单纯手术治疗组膝关节功能评分10～29分,平均(24.5±3.0)分,关节镜组膝关节功能评分12～29分,平均(26.5±3.2)分。两组膝关节功能有明显统计学差异(P<0.05),关节镜组优于单纯手术组。结论对于Schatzber分型Ⅰ～Ⅳ型胫骨平台骨折而言,关节镜辅助下骨折复位内固定能促进患者膝关节功能的恢复。

Objective To observe the effect of arthroscopy technology on the knee joint function in tibial plateau fracture patients.Methods 63 tibial plateau fracture patients with Schatzber type Ⅰ~Ⅳ underwent operations from January 2008 to January 2011 in our hospital.There were 30 cases patients received simple open reduction and internal fixation and 33 cases received arthroscopic reduction and internal fixation.All the patients were followed up at the 3 months,6 months and 12 months after operation,and the Rasmussen knee joint function scoring criteria was used for evaluation.Results For the simple open operation group and the arthroscopy assisted group,the Rasmussen knee joint function score at the 3-month-follow-up was 15.8±3.2 vs.18.8±3.0,which showed obvious statistics difference（P〈0.05）.And the Rasmussen knee joint function score at the 6-month-follow-up and 12-month-follow-up was（23.5±3.4） vs.（25.8±3.2） and（24.5±3.0） vs.（26.5±3.2） respectively.And both of these two sets of data showed significant superiorities of the arthroscopy assisted group（P〈0.05）.Conclusion The arthroscopy assisted reduction and internal fixation is help to the functional recovery of knee joint to the Schatzber-Ⅰ-Ⅳ-tibial plateau fractures.