关节镜下经皮微创钢板固定技术治疗复杂性胫骨平台骨折临床疗效观察

Clinical effect observation of arthroscopy combined with percutaneous minimally invasive plate fixation in the treatment of complex tibial plateau fractures

目的探讨关节镜下经皮微创钢板固定技术治疗复杂性胫骨平台骨折的临床疗效。方法我院接收的78例复杂性胫骨平台骨折患者,按照手术方法分为关节镜组(n=42)和传统组(n=36)。关节镜组采用关节镜下经皮微创钢板固定技术,传统组采用传统切开复位内固定术。比较两组术后关节功能、疼痛情况、离床活动时间、完全承重下地时间、骨折愈合时间、关节活动度以及创伤性关节炎、膝关节僵直、骨折畸形愈合、伤口感染情况。结果关节镜组术后HSS评分、优良率及关节活动度均高于传统组,VAS评分及并发症发生率低于传统组,离床时间、完全承重下地时间及骨折愈合时间均短于传统组(P<0.05)。结论关节镜下微创钢板固定术对膝关节功能以及疼痛的改善显著优于传统切开内固定术,具有临床疗效佳、安全性高、术后并发症少的优点,值得临床推广。

Objective To investigate the clinical effect of arthroscopy combined with percutaneous minimally invasive plate fixation in the treatment of complex tibial plateau fractures.Methods Seventy-eight patients with complex tibial plateau fractures treated in our hospital were divided into arthroscopy group(n=42)and traditional group(n=36)according to surgical methods.The arthroscopy group underwent arthroscopy combined with percutaneous minimally invasive plate fixation while the traditional group was treated with traditional open reduction and internal fixation.The joint function estimated by using HSS score,postoperative pain estimated by using VAS,time to get out of bed,time to get out of bed with full load,fracture healing time and joint mobility after surgery were compared between the two groups.The incidence of postoperative traumatic arthritis,knee stiffness,malunion and wound infection were also compared between the two groups.Results HSS score,excellent and good rate and joint mobility were higher while postoperative VAS score,incidence of postoperative complications,postoperative time to get out of bed,time to get out of bed with full load and fracture healing time were lower or shorter in the arthroscopy group than those in the traditional group(P<0.05).Conclusion Arthroscopy combined with minimally invasive plate fixation in the improving knee function and pain are significantly better than traditional open reduction and internal fixation.It has the advantages of good clinical efficacy,high safety,and fewer postoperative complications.It is worthy of clinical promotion.