关节镜辅助复位内固定与传统切开复位内固定治疗胫骨平台骨折的比较研究

Comparison between arthroscopic reduction and internal fixation with open reduction and internal fixation for treatment of Schatzker's type Ⅰ-Ⅳ tibial plateau fractures

目的比较关节镜辅助下复位内固定(ARIF)与传统切开复位内固定(ORIF)治疗胫骨平台骨折的疗效。方法选取自2010-03—2014-12诊治的SchatzkerⅠ~Ⅳ型胫骨平台骨折110例,按分层随机分组分为ARIF组和ORIF组,术后12个月随访观察2组疗效。结果 ORIF组手术时间(90.4±11.1)min,ARIF组手术时间(119.3±17.2)min,ORIF组手术时间较ARIF组短,差异有统计学意义(P<0.05);ARIF组53例中51例达到解剖复位,ORIF组57例中48例达到解剖复位;术后6个月ARIF组的膝关节功能优于ORIF组,差异有统计学意义(P<0.05);2组术中失血量、切口大小、并发症、术后疗效差异均无统计学意义(P>0.05)。结论 ARIF技术有利于提高胫骨平台骨折复位质量,具有康复快的优点,提高了胫骨平台骨折的疗效。

Objective To compare the clinical outcomes of arthroscopic reduction-internal fixation （ARIF） and open reduction-internal fixation （ORIF） for tibial plateau fractures. Methods From March 2010 to December 2014, 110 patients were included in this study based on fracture patterns and divided into two groups. The data of each group were collected for statistical analysis on the following. Results The duration of operation was （119.3±17.2）min in group ARIF and （90.4 ± 11.1 ）min in group ORIF （P 〈0.05）. In group ARIF, however, 51 of 53 patients obtained an anatomical reduction, whereas in group ORIF, only 48 of 57 patients had an anatomical reduction. Furthermore, the postoperative rehabilitation was faster in group ARIF （P 〈0.05）. There was no significant difference between both groups in terms of blood loss, postoperative complications, and post-operative function（P 〉0.05）. Conclusion ARIF can improve the clinical efficacy in the treatment of tibial plateau fractures, which can improve fractures reduction and promote patients＇ early rehabilitation.