关节镜监视复位排钉技术固定治疗Schatzker Ⅱ~Ⅲ型胫骨平台骨折

Arthroscopic Reduction and Raft Screws Technique Fixation for Schatzker Ⅱ and Ⅲ Tibial Plateau Fractures

目的探讨关节镜监视复位排钉技术固定治疗Schatzker Ⅱ~Ⅲ型胫骨平台骨折的临床效果。方法回顾性分析2014年7月至2017年10月我院收治的28例Schatzker Ⅱ~Ⅲ型胫骨平台骨折患者的临床资料,均为单侧骨折,左侧12例,右侧16例。骨折分型:Ⅱ型15例,Schatzker Ⅲ型13例。均于关节镜监视下行点对点前交叉韧带定位器定位,4.5空心钻钻至平台软骨下骨,4.0斯氏针推顶复位,排钉板固定。结果本组28例均完成关节镜下复位排钉板固定,手术时间平均72.2(56~89)min,术中出血量平均86.5(50~220)ml,住院时间平均8.6(6~15)d。所有患者均未出现感染,亦无内固定物松动断裂发生。本组患者均获得随访,随访时间平均25(13~40)个月。所有患者术后10~17周骨折均愈合,无膝关节活动受限或膝关节内外翻畸形。术后1年采用Rasumssen评分评定膝关节功能:优22例,良3例,可3例,优良率为89.3%。结论关节镜监视复位排钉技术固定治疗Schatzker Ⅱ~Ⅲ型胫骨平台骨折临床效果确切,关节面平整,患者可早期锻炼,功能恢复良好。

Objective To explore the clinical effect of arthroscopic reduction and raft screws technique fixation for Schatzker Ⅱ and Ⅲ tibial plateau fractures.Methods A retrospective analysis was performed in 28 tibial plateau fracture patients admitted to our hospital from July 2014 to October 2017,including 15 patients of Schatzker Ⅱ and 13 patients of Schatzker Ⅲ.Under arthroscopic monitoring,the point-to-point ACL locator was used for localization,raft screws technique fixation was performed after reduction.Results All cases were accomplished the internal fixation with raft screws technique under arthroscope with operation time of 56 to 89 min(mean 72.2 min),intra-operative blood loss volume of 50 to 220 ml(mean 86.5 ml)and hospitalization time of 6 to 15 days(mean 8.6 days).The fractures achieved healing during 10 to 17 weeks with an average of 11.8 weeks.There was no knee joint mobility limitation and knee varus deformity.Rasumssen Score revealed that excellence in 22 cases,good in 3 cases and fair in 3 cases,and the fineness rate was 89.3%.Conclusion The surgery of arthroscopic reduction and raft screws technique fixation can achieve a precise effect with flat articular surface,less complication,early exercise and satisfied functional recovery for Schatzker Ⅱ and Ⅲ tibial plateau fractures.