关节镜辅助复位与切开复位治疗胫骨平台骨折的疗效分析

Arthroscopic management of tibial plateau fractures: comparison with open reduction method

目的评价关节镜辅助复位治疗胫骨平台骨折与传统切开复位在手术创伤及术后近期功能恢复上的差异性。方法回顾分析近年手术治疗的SchatzkerⅠ～Ⅳ型胫骨平台骨折60例,关节镜组29例,传统手术组31例,比较手术时间、术中出血量、术后Rasmussen放射评分及术后1年Rasmussen功能评分。结果两组手术时间无统计学差异,关节镜组术中出血量少(P<0.05),术后Rasmussen放射评分及术后1年Rasmussen功能评分优良率优于传统手术组(P<0.05)。结论关节镜辅助复位治疗胫骨平台骨折(SchatzkerⅠ～Ⅳ型)较传统手术具有手术创伤小、骨折复位满意度高及术后近期功能恢复好等优点,但娴熟的操作技术和适应证的选择是提高手术成功率的关键。

Objective To evaluate the differences of the arthrescopic -assisted reduction and traditional open reduction in surgical trauma and postoperative functional recovery for the treatment of tibial plateau fractures. Methods Sixty cases of Schatzker I- IV tibial plateau fracture who received surgical treatment in recent years were retrospectively analyzed. Among them, 29 were treated by arthroscopic -assisted reduction, 31 received convention- al surgery. Surgery time, blood loss, and Rasmussen radiological and functional scores 1 year after operation were compared. Results There was no significant difference in operative time. The group of arthroscopic -assisted reduction had less blood loss （ P 〈0.05）. The good rates of postoperative Rasmussen radiological and functional scores 1 year after surgery were superior to conventional surgery group （ P 〈0.05）. Conclusion Compared with traditional surgery, arthrescopic - assisted reduction for tibial plateau fracture （ Schatzker typeI - IV ） has the advantages of minimal invasive, satisfactory reduction and good functional recovery. Skilled technique and correct selection of patients with indications are the keys to improve the success rate of surgery.