关节镜辅助下经皮复位内固定微创术结合中药熏蒸对胫骨平台骨折合并交叉韧带损伤患者膝关节功能的影响

Impacts of arthroscopic assisted percutaneous reduction and internal fixation minimally invasive surgery combined with Chinese materia medica fumigation on knee joint function of patients with tibial plateau fracture complicated with cruciate ligament injury

目的探究关节镜辅助下经皮复位内固定微创术结合中药熏蒸对胫骨平台骨折合并交叉韧带损伤患者手术情况、膝关节活动度、膝关节功能、并发症及生活质量的影响。方法回顾性研究2019年3月至2021年4月厦门市第五医院病例资料,根据治疗方法不同将90例胫骨平台骨折合并交叉韧带损伤患者分为常规组与试验组,每组各45例,其中常规组患者实施常规手术切开复位内固定手术,试验组则实施关节镜辅助下经皮复位内固定微创术,两组患者均结合中药熏蒸治疗,治疗结束后比较两组患者的治疗效果、膝关节功能、膝关节活动度、生活质量、并发症及手术相关情况。结果试验组总有效率、Lysholm膝关节功能量表(LKS)评分、膝关节活动度、胫骨骨隧道宽度水平、生活质量调查表(SF-36)评分高于常规组,差异有统计学意义(P<0.05);试验组患者的住院时间、切口长度、手术时间、术中出血量、术后并发症总发生率低于常规组,差异有统计学意义(P<0.05)。结论胫骨平台骨折合并交叉韧带损伤患者实施关节镜辅助下经皮复位内固定微创术结合中药熏蒸可恢复膝关节功能,减少术中出血量及术后并发症。

Objective To investigate the impacts of arthroscopic assisted percutaneous reduction and internal fixation minimally invasive surgery combined with Chinese materia medica fumigation on the operation,knee joint mobility,knee joint function,complications and quality of life(QoL)of patients with tibial plateau fracture complicated with cruciate ligament injury.Methods The case data in the Fifth Hospital of Xiamen from March 2019 to April 2021 were collected and retrospectively studied.According to different treatment methods,a total of 90 patients with tibial plateau fracture complicated with cruciate ligament injury were divided into the conventional group(n=45)and the experimental group(n=45).Patients in the conventional group were treated with conventional open reduction and internal fixation,while those in the experimental group were treated with arthroscopic assisted percutaneous reduction and internal fixation minimally invasive surgery.Both groups of patients were treated with Chinese materia medica fumigation.After the treatment,the therapeutic efficacy,knee joint function,knee joint mobility,QoL,complications and operation related conditions of the two groups of patients were compared.Results The overall response rate,lysholm knee function scale(LKS)score,knee joint mobility,width level of tibial tunnel and quality of life questionnaire(SF-36)score of the experimental group were higher than those of the conventional group,with statistically significant differences(P<0.05).The hospitalization time,incision length,operation duration,intraoperative hemorrhage volume and the total incidence of postoperative complications of patients in the experimental group were lower than those of patients in the conventional group,with statistically significant differences(P<0.05).Conclusion Arthroscopic assisted percutaneous reduction and internal fixation minimally invasive surgery combined with Chinese materia medica fumigation can restore knee joint function,reduce intraoperative hemorrhage volume and decrease postoperative complications in patients with tibial plateau fracture complica ted with cruciate ligament injury.