膝关节镜微创手术治疗胫骨内侧平台骨折的临床研究

Clinical Study on Minimally Invasive Knee Arthroscopic Surgery in the Treatment of Medial Tibial Plateau Fracture

目的：探讨膝关节镜辅助下采用微创手术治疗老年胫内平台骨折的临床疗效及安全性。方法：按照随机数字表法将2012年1月-2014年1月我院骨科收治的老年胫骨内侧平台骨折患者分为两组，治疗组行膝关节镜辅助下微创手术治疗，对照组行常规手术固定治疗，比较两组的临床疗效及安全性。结果：治疗组的手术时间、术中出血量、术后引流量及住院时间均小于对照组。差异有统计学意义（P〈0．05）；治疗组的HSS评分优于对照组，差异有统计学意义（Z=2．015，P=0．044）；两组术后并发症主要有伤口化脓、骨折畸形、膝关节僵直、创伤性关节炎以及伤口软组织不同程度的感染，治疗组发生率16．67％，对照组40．00％，两组差异有统计学意义（P〈0．05）。结论：老年胫骨内侧平台骨折在膝关节镜辅助下采用微创手术治疗能够有效减轻患者疾病负担，且具有临床疗效好、安全性高等特点，临床有重要参考价值。

Objective： To explore the clinical efficacy and safety of knee arthroscopy-assisted minimally invasive surgery in the treatment of medial tibial plateau fracture for elderly patients. Methods： Elderly patients with medial tibial plateau fracture admitted in the Department of Orthopaedics in our hospital from January 2012 to 2014 were selected and randomly divided into two groups. The patients in the treatment group taken the knee arthroscopy-assisted minimally invasive surgery, while the patients in the control group taken the conventional fixation surgery. Then the clinical efficacy and safety of patients in the two groups were compared. Results： The operation time, intraoperative blood loss, postoperative drainage volume and hospitalization of patients in the treatment group were lower than those of the patients in the control group with statistically significant differences （P〈0.05）. HSS scores of patients in the treatment group were better than those of the patients in the control group with statistically significant differences （Z=2.015, P=0.044）. Postoperative complications included suppuration, faeture deformity, rigidity of knee joint, traumatic arthritis and various degrees of infection of soft tissues of the wound. The incidence of postoperative complications in the treatment group was 16.67% which was lower than 40.00% in the control group with statistically significant differences （P〈0.05）. Conclusion： Knee arthroseopy-assisted minimally invasive surgery in the treatment of medial tibial plateau fracture in elderly patients could effectively alleviate the disease burden of the patients with good clinical efficacy and high level of safety, which is important for clinical treatment.