微创结合开放手术对胫骨平台骨折合并半月板的临床疗效观察

The Clinical Effect of Minimally Invasive Combined with Open Surgery for Tibia Plateau Fractures with Meniscus Injury

目的:探讨胫骨平台骨折合并半月板损伤的发生率及微创结合开放手术的临床疗效。方法:选择胫骨平台骨折合并半月板损伤患者360例,分析Schatzter分型方法分析各型的发生率;将Ⅰ型以及部分关节面无塌陷的Ⅳ型和Ⅴ型胫骨平台骨折合并半月板损伤患者,分别采取微创结合开放手术治疗组和常规开放手术治疗组。观察两种损伤类型中各组患者的手术疗效、术后并发症发生率和术后膝关节功能。结果:SchatzkerⅠ型、Ⅱ型、Ⅲ型、Ⅳ型、Ⅴ型、Ⅵ型胫骨平台骨折合并半月板损伤的发生率分别为19.2%、47.7%、20.8%、21.5%、29.8%和35.7%,胫骨平台骨折合并半月板损伤总体发生率为28.6%。与常规开放手术治疗方案相比,微创结合开放手术治疗方案术后并发症发生率无明显改善(P>0.05),手术疗效(P <0.01)和术后膝关节功能显著提高(P <0.05)。结论:微创结合开放手术治疗方案的临床疗效要显著高于常规开放手术治疗方案。

Objective:To investigate the incidence of tibia plateau fractures with meniscus injury and the clinical effect of minimally invasive combined with open surgery.Methods:The incidence of tibia plateau fractures combined with meniscus injury in the type of Schatzter of 360 patients was calculated.Then the patients of typeⅠand part of the joint surface didn't subsidenceⅣandⅤtibial plateau fractures combined with meniscus injury were divided into minimally invasive open surgery treatment group and conventional open surgery treatment group.The surgical efficacy,the incidence of postoperative complications and the postoperative knee function were observed in the two groups of different injury type.Results:In 360 patients,the incidence of SchatzkerⅠ,ⅡⅢ,ⅣⅤ,Ⅵtibial plateau fractures combined with meniscus injury was 19.2%,47.7%,20.8%,21.5%,29.8%and 35.7%,the overall incidence of 28.6%.Compared with the conventional open surgery treatment group,minimally invasive combined with open surgery regimen showed no significant improvement in the incidence of postoperative complications(P>0.05),and significantly increased the surgical efficacy(P<0.01)and postoperative knee joint function(P<0.05).Conclusion:The clinical effect of minimally invasive combined with open surgery was significantly higher than that of conventional open surgery treatment.