“撬拨植骨”在镜下治疗胫骨平台骨折的运用

Poking Bone Graft Use in the Endoscopic Treatment of Tibial Plateau Fractures

目的：通过关节镜辅助下对SchatzkerI～III型胫骨平台骨折进行复位和内固定提升治疗效果。方法：对2007年9月至2011年11月手术治疗的31例骨质疏松相关胫骨平台骨折（塌陷≥3mm）的患者进行回顾性分析,男5例,女26例;年龄51~74岁,平均年龄61.3岁;随访时间1~2年,平均1.5年。均采用关节镜辅助下复位、植骨、MIPPO技术LCP内固定。用HSS评分评价治疗效果。结果：30例患者均在术后第二天能主动屈曲≥90°,30例患者获得随访,所有随访患者均在术后20周内弃拐行走,HSS评分73~100分,平均88分。未出现感染、DVT等并发症。结论：关节镜辅助下微创治疗骨质疏松相关的胫骨平台骨折能取得很好的疗效,运用＂撬拨植骨＂的方法能够获得更加满意的手术效果。

Objective： To enhance treatment effects through arthroscopy-assisted reduction and inter-fixation of tibial plateau fractures of the Schatzker I ~ III.Methods： Retrospective study on 31 cases of osteoporosis-related tibial plateau fractures（collapse ≥ 3mm） treated by surgery in.September 2007 to November 2011,5 males and 26 females;age 51~74 years,the average age 61.3 years;1~2 years of follow-up time,an average of 1.5 years.all cases are treated by arthroscopically assisted resetting,bone grafting and internal fixation MIPPO technology with LCP.Therapeutic effect are evaluated by HSS score.Result： 30 patients were followed-up,All patients can active flexion90 degree in the very next day postoperatively.All patients walk no longer relying on crutche within 20 weeks after surgery,HSS score 73 ~ 100points,an average of 88 points.all patients had no complications such as infection,DVT.Conclusion： osteoporosis-related tibial plateau fractures treated by arthroscopy assisted operative and poking the bone grafting,as a minimally invasive,Can achieve good effect.