关节镜辅助下复位内固定治疗胫骨平台骨折的临床疗效

Clinical effect of arthroscopic assisted reduction and internal fixation for tibial plateau fracture

目的探讨关节镜辅助下复位内固定治疗胫骨平台骨折的临床疗效。方法从2018年2月至2019年10月间河南大学第一附属医院收治的胫骨平台骨折患者中选取82例作为研究对象,以随机数表将所有患者分为对照组和观察组,分别为40例、42例。对照组行传统切开复位内固定手术治疗,观察组则在关节镜辅助下行复位内固定治疗。比较两组患者的手术基本情况、治疗疗效及患者膝关节功能评分变化。结果观察组患者的手术时间短于对照组,术中出血量少于对照组,切口长度短于对照组,比较差异均有统计学意义(P<0.05)。观察组术后4 h、12 h、24 h、48 h VAS评分均低于对照组,比较有统计学意义(P<0.05)。观察组术后1个月、3个月美国特种外科医院膝关节评分(HSS)高于对照组(P<0.05);而在术前、术后6个月HSS功能评分比较,差异无统计学意义(P>0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。结论关节镜辅助下行复位内固定治疗胫骨平台骨折的疗效较好,具有出血少、疼痛程度低,恢复快的优点,值得推广使用。

【Objective】To investigate the clinical effect of arthroscopically assisted reduction and internal fixation in the treatment of tibial plateau fracture.【Methods】Eighty-two patients with tibial plateau fracture treated in our hospital from February 2018 to October 2019 were selected as the study subjects,and all patients were divided into control group and observation group with random number table,40 cases and 42 cases,respectively.The control group was treated with traditional open reduction and internal fixation,while the observation group was treated with arthroscopic assisted reduction and internal fixation.The basic conditions of operation,therapeutic efficacy and changes of knee joint function scores were compared between the two groups.【Results】The operation time of the patients in the observation group was shorter than that in the control group,the amount of intraoperative bleeding was less than that in the control group,and the length of incision was shorter than that in the control group,the comparison was statistically significant(P<0.05).The VAS scores of the observation group at 4 h,12 h,24 h and 48 h after operation were lower than those of the control group,with statistical significance(P<0.05).The HSS(Hospital for Special Surgery)score of knee joint function in the observation group was higher than that in the control group at 1 and 3 months after operation(P<0.05),but there was no statistical significance in the comparison of HSS score before and 6 months after operation(P>0.05).The total effective rate in the observation group was higher than that in the control group,with statistical significance(P<0.05).【Conclusion】Arthroscopyassisted reduction and internal fixation for tibial plateau fracture has good curative effect,with the advantages of less bleeding,less pain and faster recovery,which is worthy of popularization.