关节镜下前交叉韧带定位器结合空心顶棒复位固定治疗胫骨平台骨折的疗效分析

Efficiency of arthroscopic anterior cruciate ligament locator combined with hollow lifting stick reduction and fixation in treatment of tibial plateau fracture

目的分析关节镜辅助下前交叉韧带定位器结合空心顶棒复位治疗胫骨平台骨折(SchatzkerⅠ~Ⅳ型)的疗效。方法采用关节镜辅助下前交叉韧带定位器结合空心顶棒打压复位方案,采用经皮空心钉或经皮锁定钢板固定治疗26例SchatzkerⅠ~Ⅳ型胫骨平台骨折患者。结果26例患者术后均获随访10~24个月,平均16.0个月。26例患者骨折均获得骨性愈合,无患者发生切口感染或关节感染。根据Rasmussen胫骨平台骨折膝关节功能评分标准,本组患者疗效评估为优17例,良7例,可2例,优良率为92.3%。结论关节镜辅助下前交叉韧带定位器结合空心顶棒复位固定治疗胫骨平台骨折疗效显著,具有创伤小、复位和固定精准、关节功能恢复良好、并发症少等优点,并可同时行半月板、交叉韧带等关节内其他结构的探查和治疗。

Objective To analyze the effect of arthroscopic anterior cruciate ligament locator combined with hollow lifting stick reduction in the treatment of tibial plateau fractures(Schatzker type ofⅠtoⅣ).Methods Plan of arthroscopic anterior cruciate ligament locator combined with hollow ejector rod reduction was adopted,and 26 patients with tibial plateau fractures classified as Schatzker type ofⅠtoⅣwere treated with percutaneous cannulated screw or percutaneous locking plate fixation.Results A total of 26 patients were followed up for 10 to 24 months,with an average of 16.0 months.A total of 26 patients had bone healing,and no patients had incision infection or joint infection.According to Rasmussen knee function scoring criteria for tibial plateau fractures,the curative effect of 26 patients evaluated as excellent efficacy in 17 cases,good efficacy in 7 cases and common efficacy in 2 cases,with an excellent and good rate of 92.3%.Conclusion Arthroscopic anterior cruciate ligament locator combined with hollow lifting stick reduction and fixation is effective in the treatment of patients with tibial plateau fractures,which has the advantages of less trauma,accurate reduction and fixation,good recovery of joint function and less complications,and it also can explore and treat other structures in the joint such as meniscus and cruciate ligament at the same time.