关节镜在胫骨平台骨折诊治中的应用

Application of arthroscopy in the diagnosis and treatment of tibial plateau fractures

胫骨平台骨折是下肢负重关节的关节内骨折，约占全身骨折的1%[1]，其主要由交通事故或高处坠落伤等高能量所致，胫骨平台受到外力挤压或撞击时容易造成劈裂或塌陷，产生不同程度的膝内、外翻畸形，严重者还可合并半月板或韧带损伤等周围组织损伤[2]，处理不当常导致膝关节功能恢复不良[3]。传统的切开复位内固定术式严重破坏膝关节周围软组织环境并且不能对骨折伴随损伤妥善处理，由此导致的膝关节并发症经常被报道。近年来关节镜技术快速发展，且已广泛应用于胫骨平台骨折诊疗，关节镜微创技术在胫骨平台骨折治疗中的应用受到越来越多的关注[4]。现就近年来的研究进展综述如下。

Tibial plateau fractures belong to intra-articular fractures of the main weight-bearing joints of lower limbs. Traumatic osteoarthritis of the knee is mainly caused by articular surface collapse, joint deformities and joint instabilities after fractures. Therefore, the ideal target in the treatment of tibial plateau fractures is to obtain stable and painless knee joints with good counterpoint and alignment and normal range of motion, and to minimize the occurrence of traumatic osteoarthritis. In recent years, the widespread use of arthroscopic technique promotes the new progress in the diagnosis and treatment of tibial plateau fractures. In this article, the application of arthroscopy in the diagnosis and treatment of tibial plateau fractures was introduced, including the classiifcation of tibial plateau fractures, indications and contraindications of arthroscopic surgery, prevention and management of special problems of arthroscopic-assisted treatment of tibial plateau fractures and advantages and limitations of arthroscopic-assisted treatment of tibial plateau fractures versus traditional open reduction and internal ifxation. The progress of arthroscopy in the diagnosis and treatment of tibial plateau fractures was summed up, so as to provide reference for the clinical diagnosis and treatment of tibial plateau fractures.