膝关节镜引导小切口复位内固定治疗胫骨平台骨折的效果

Effect of Knee Arthroscopic Guided Small Incision Reduction and Internal Fixation in the Treatment of Tibial Plateau Fracture

目的:探讨膝关节镜引导小切口复位内固定治疗胫骨平台骨折的效果。方法:选取2020年1月—2022年12月崇阳县中医院收治的90例胫骨平台骨折患者。根据随机数表法将其分为观察组及对照组,各45例。对照组给予切开复位内固定术,观察组给予膝关节镜引导小切口复位内固定。比较两组围手术期指标,术前1 d、术后7 d膝关节活动度,术前1 d、术后3个月膝关节功能、生活质量及并发症。结果:观察组手术时间、住院时间、骨折愈合时间均短于对照组,术中出血量少于对照组,术后首次下床时间早于对照组,差异有统计学意义(P<0.05)。术后7 d,观察组伸膝最大角度、屈膝最大角度均大于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组疼痛、功能、关节活动度、肌力、屈膝畸形、稳定性评分均高于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组生理机能、情感职能、精神健康、社会功能评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:膝关节镜引导小切口复位内固定创伤小、恢复快,可改善患者膝关节功能,提高患者生活质量,且术后并发症发生率低。

Objective:To investigate the effect of knee arthroscopic guided small incision reduction and internal fixation in the treatment of tibial plateau fracture.Method:A total of 90 patients with tibial plateau fracture admitted to Chongyang County Traditional Chinese Medicine Hospital from January 2020 to December 2022 were selected.They were divided into observation group and control group according to random number table method,45 cases in each group.The control group was given open reduction and internal fixation,and the observation group was given knee arthroscopic guided small incision reduction and internal fixation.Perioperative indexes,knee joint activity 1 d before surgery and 7 d after surgery,knee joint function,quality of life 1 d before surgery and 3 months after surgery and complications were compared between the two groups.Result:The operation time,hospital stay and fracture healing time in the observation group were shorter than those in the control group,the intraoperative blood loss volume was less than that in the control group,and the first time of getting out of bed after surgery was earlier than that in the control group,the differences were statistically significant(P<0.05).On the 7 d after surgery,the maximum knee extension angle and the maximum knee bend angle in the observation group were greater than those in the control group,and the differences were statistically significant(P<0.05).At 3 months after surgery,the scores of pain,function,joint motion,muscle strength,flexion deformity and stability in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).At 3 months after surgery,the physiological function,emotional function,mental health and social function scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Knee arthroscopic guided small incision reduction and internal fixation have the minimal trauma,fast recovery,can improve knee joint function,improve quality of life of patients,and it has low incidence of postoperative complications.