关节镜与传统切开手术治疗胫骨平台骨折合并前交叉韧带撕脱的效果比较

Effect analysis of surgical treatment for tibial plateau fracture combined with anterior cruciate ligament tear off under arthroscopy

目的探讨关节镜辅助治疗胫骨平台骨折合并前交叉韧带(ACL)撕脱的临床效果。方法选择郑州市骨科医院关节镜科自2010年1月至2015年6月收治的86例胫骨平台骨折合并ACL撕脱患者为研究对象,所有患者根据自身意愿分为对照组和观察组。对照组患者接受传统的切开复位内固定术治疗,观察者实施关节镜下复位内固定术治疗。比较两组患者手术情况、术后膝关节功能及临床效果差异。结果观察组患者术中出血量、住院时间和骨折愈合时间均明显小于对照组患者,而手术时间大于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者术后HSS评分、Lysholm评分和Rasmussen评分均明显高于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者术后优良率明显高于对照组患者,差异有统计学意义(89.58%vs.63.16%,χ~2=3.876,P<0.05)。结论关节镜辅助治疗胫骨平台骨折合并前交叉韧带撕脱临床效果优于切开复位内固定术,对机体创伤小,值得在临床中推广应用。

Objective To discuss the clinical effect of surgical treatment for tibial plateau fracture combined with anterior cruciate ligament（ACL） tear off under arthroscopy. Methods Totally 86 cases with tibial plateau fracture combined with ACL admitted at our hospital from 2010 January to 2015 June were selected and divided into the control group and observation group according to their own wishes. The patients of control group were undergone the traditional open reduction and internal fixation treatment and the patients of observation group were given reduction and internal fixation treatment under arthroscopy. To compare the operation situation,postoperative knee function and clinical effect between the two groups. Results The intraoperative blood loss,hospitalization time and fracture healing time of observation group were obviously lower than those the control group,while the operating time was greater than the control group patients,the differences were statistically significant（all P〈0. 05）. The HSS score,Lysholmscore and Rasmussen score of observation group were obviously higher than that of the control group（all P〈0. 05）. The excellent and good rates after treatment of observation group were obviously higher than those the control group（89. 58% vs. 63. 16%,χ^2= 3. 876,P〈0. 05）.Conclusion The clinical effect of surgical treatment for tibial plateau fracture combined with anterior cruciate ligament tear off under arthroscopy is better than traditional open reduction and internal fixation treatment,it causes more little damage and is worth popularization and application.