关节镜辅助下经皮撬拨复位固定胫骨平台骨折(SchatzkerⅠ~Ⅲ型)的临床研究

Clinical study of arthroscopic-assisted percutaneous prying reduction and fixation of tibial plateau fracture(SchatzkerⅠ-Ⅲtype)

目的探讨关节镜辅助下经皮撬拨复位固定胫骨平台骨折(Schatzker Ⅰ~Ⅲ型)的临床疗效。方法选择2018年10月~2020年1月我院收治的40例胫骨平台骨折(Schatzker Ⅰ~Ⅲ型)患者为研究对象,随机分为治疗组(n=20)和对照组(n=20);其中对照组予以传统切开撬拨复位固定术治疗,治疗组予以关节镜辅助下经皮撬拨复位固定治疗;观察比较两组的手术相关指标、术后VAS疼痛评分、术后并发症发生情况及膝关节功能优良率。结果(1)治疗组手术时间、切口长度及术后住院时间明显短于对照组(P<0.05),术中出血量明显少于对照组(P<0.05)。(2)术后12 h,治疗组VAS评分明显低于对照组(P<0.05)。(3)治疗组术后并发症总发生率为15.00%,明显低于对照组的35.00%(P<0.05)。(4)治疗组膝关节功能优良率为95.00%,明显高于对照组的80.00%(P<0.05)。结论关节镜辅助下经皮撬拨复位固定胫骨平台骨折疗效确切,创伤小,痛苦小,恢复快,并发症发生率低,更有利于膝关节功能恢复。

Objective To explore the clinical efficacy of arthroscopic-assisted percutaneous prying reduction and fixation of tibial plateau fracture(TPF)(SchatzkerⅠ-Ⅲtype).Methods From October 2018 to January 2020,a total of 40 patients with TPF(SchatzkerⅠ-Ⅲtype)admitted to and treated in our hospital were selected as the subjects of research and randomly divided into two groups:the treatment group(n=20)and the control group(n=20).Between them,the control group was treated with traditional incision prying reduction and fixation,while the treatment group was treated with arthroscopic-assisted percutaneous prying reduction and fixation.The operation-related indexes,the postoperative VAS scores,the occurrence of postoperative complications and excellent and good rate of knee joint function of the two groups were observed and compared.Results i.The operation duration,incision length and postoperative hospitalization time of the treatment group were significantly shorter than those of the control group(P<0.05),and the intraoperative blood loss was significantly less than that of the control group(P<0.05).ii.12 h after operation,the VAS scores of the treatment group were significantly lower than those of the control group(P<0.05).iii.The total incidence of postoperative complications of the treatment group was 15.00%,which was significantly lower than the 35.00%of the control group(P<0.05).iv.The excellent and good rate of knee joint function of the treatment group was 95.00%,which was significantly higher than the 80.00%of the control group(P<0.05).Conclusion Arthroscopic-assisted percutaneous prying reduction and fixation of TPF have definite efficacy.The therapy incurs less trauma and pain,but brings quick recovery and low incidence of complications.It is more conducive to the recovery of knee joint function.