关节镜辅助下内固定治疗胫骨平台骨折的临床疗效观察

Effect of the arthroscopy-assisted treatment on tibia plateau fracture with internal fixation

目的探讨关节镜辅助下内固定治疗胫骨平台骨折的临床疗效。方法收集45例胫骨平台骨折在我院接受治疗的回顾性资料,按已完成的手术分为对照组和观察组。对照组19例采用传统切开复位内固定治疗,观察组26例采用关节镜辅助下微创内固定治疗。采用Lysholm膝关节功能评分表对患者膝关节功能进行评价,评价关节镜下骨折复位固定的临床疗效、住院时间及术后不良情况。所有患者术后均随访6~18个月。结果观察组患者住院时间短于对照组,两组比较差异显著（P〈0.05）。观察组患者总体疗效显著优于对照组,差异有统计学意义（P〈0.05）。术前胫骨平台骨折患者Lysholm评分显著低于术后患者,两者比较差异有统计学意义（P〈0.01）。观察组术后Lysholm膝关节功能评分显著高于对照组患者（P〈0.01）。结论关节镜辅助下内固定治疗胫骨平台骨折疗效显著,并优于切开复位内固定治疗,可作为胫骨平台骨折治疗的首选方法。

Objective To observe the effect of arthroscopic treatment for tibia plateau fractures. Methods Forty-five patients with tibia plateau fractures were divided into control group and observation group ： the control group（n =19） was treated with traditional open reduction and fixation,and observation group（n =26） was treated with fracture reduction and fixation under arthroscopy.Preoperative and postoperative Lysholm score was assessed. The effect of the fixation under arthroscopy,hospital stay, and postoperative adverse situation were also evaluated. All patients were followed up for6 to 18 months. Results The patients in obejenation group had shorter haspital stay than that of control group（P〈0.05）. Preoperative Lysholm score was significantly lower than in patients with postoperative patients（P〈0.01）. The Lysholm score of observation was significantly higher than control group（P〈0.05）. Conclusion The arthroscopy treatment is better than traditional open reduction and fixation in tibia plateau fracture, which can be used as a preferred method for tibia plateau fracture.