膝关节镜辅助小切口内固定术治疗胫骨平台骨折的可行性

Feasibility of knee arthroscopy assisted small incision internal fixation in treatment of tibial plateau fractures

目的研究分析膝关节镜辅助小切口内固定术治疗胫骨平台骨折的可行性。方法选取2016年11月~2018年4月间于我院骨科就诊的136例确诊胫骨平台骨折患者作为研究对象,将全部患者随机分为实验组和对照组,每组78例,对照组给予传统切开复位内固定术,实验组给予膝关节镜辅助小切口复位内固定术,采取美国特种外科医院膝关节评分(HSS)评定膝关节功能恢复状况,对比两组患者临床基本指标及术后并发症的发生情况。结果经过不同方法治疗后,实验组膝关节功能优良率显著高于对照组(P<0.05),实验组患者手术时间显著长于对照组(P<0.05),术后引流量显著少于对照组(P<0.05),住院时间及下床活动时间均显著短于对照组(P<0.05),实验组术后并发症总发生率显著低于对照组(P<0.05)。结论膝关节镜辅助小切口内固定术治疗胫骨平台骨折相比于传统切开复位内固定术膝关节功能改善更为明显,手术并发症的发生率较低,疗效显著,值得临床推广应用。

Objective To study and analyze the feasibility of knee arthroscopy assisted small incision internal fixation in treatment of tibial plateau fractures. Methods 136 patients with confirmed tibial plateau fractures who were treated in department of orthopedics in our hospital from November 2016 to April 2018 were selected as research objects.All patients were randomly divided into the experimental group and the control group,with 78 cases in each group.The control group was treated with traditional open reduction and internal fixation while the experimental group was treated with knee arthroscopy assisted small incision internal fixation.The recovery of knee joint function was assessed by the hospital for special surgery knee score (HSS).Clinical basic indexes and the occurrence of postoperative complications were compared between the two group. Results After treatment by adopting different methods,the excellent and good rate of knee joint function of the experimental group was significantly higher than that of the control group (P < 0.05).The operation time of the experimental group was significantly longer than that of the control group (P < 0.05).The postoperative drainage of the experimental group was significantly less than that of the control group (P < 0.05).The hospital saty and time of getting out of bed of the experimental group were significantly less than those of the control group (P < 0.05).The total incidence of postoperative complications in the experimental group was significantly lower than that in the control group (P < 0.05). Conclusion Knee arthroscopy assisted small incision internal fixation in treatment of tibial plateau fractures can more significantly improve knee joint function than traditional open reduction and internal fixation.The incidence of surgical complications is low and its curative effect is significant.It is worthy of clinical promotion and application.