目的研究老年胫骨内平台骨折在膝关节镜辅助下实施微创手术治疗效果。方法选取本院诊治的老年胫骨内平台骨折患者112例,按患者入院顺序随机分为对照组和观察组,各56例。对照组实施常规手术固定,观察组在膝关节镜辅助下实施微创手术,2组...目的研究老年胫骨内平台骨折在膝关节镜辅助下实施微创手术治疗效果。方法选取本院诊治的老年胫骨内平台骨折患者112例,按患者入院顺序随机分为对照组和观察组,各56例。对照组实施常规手术固定,观察组在膝关节镜辅助下实施微创手术,2组均于术后实施为期6个月随访复查。观察2组围术期指标、手术前及术后6个月膝关节功能及术后并发症。结果观察组切口长度为(3.53±0.81)cm,明显短于对照组的(9.24±2.33)cm;观察组手术时间为(1.71±0.82)h,明显短于对照组的(2.64±1.04)h;观察组骨折愈合时间为(12.33±3.47)周,明显短于对照组的(16.65±3.76)周;观察组住院时间(13.35±1.27)d,明显短于对照组的(18.91±2.51)d,差异均有统计学意义(P<0.001)。术后观察组美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS评分)为(90.52±5.54)分,与对照组的(91.64±5.33)分比较,差异无统计学意义(P>0.05);术后观察组美国膝关节协会评分(knee society knee score,KSS评分)为(93.37±5.21)分,与对照组的(90.02±5.14)分比较,差异无统计学意义(P>0.05)。观察组并发症发生率为10.71%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论膝关节镜辅助下的微创手术效果较好,可降低老年胫骨内平台骨折患者术后并发症发生率,同时缩短患者恢复时间,且术后膝关节功能恢复较好。展开更多
Intraarticular nonunion of tibial plateau is rare. In the literature, only 9 patients were found to be treated for intraarticular tibial plateau nonunion and they got varying results. Internal fixation along with bone...Intraarticular nonunion of tibial plateau is rare. In the literature, only 9 patients were found to be treated for intraarticular tibial plateau nonunion and they got varying results. Internal fixation along with bone grafting was done as a standard treatment in all cases. We treated 4 different profile cases of intraarticular tibial plateau nonunion in our institution by 4 different methods. We treated these cases with plaster of paris cast, internal fixation along with bone graft, arthrodesis with K-nail and total knee replacement. Case 1 was treated with plaster of paris （POP） cast as the patient refused surgery. The fracture was united and the patient was fully satisfied with full range of motion despite valgus malalignment. Case 2 was managed with open reduction internal fixation along with bone grafting. Thepatient had a good union and got full range of motion at the knee joint. Case 3 was treated with total knee arthroplasty due to her old age and got satisfactory result. Case 4 was an infected nonunion. Arthrodesis was done and the patient could walk with full weight bearing independently. We conclude that internal fixation along with bone grafting may not be suitable in all cases of intraarticular nonunion of tibial plateau. Causes of nonunion, present condition and range of motion of the knee joint, as well as the age of patient should be all considered and the treatment should be individualised according to each patient＇s situation.展开更多
Objective： To study the effect of internal fixation performed at different times on therapeutic outcomes of Schatzker IV-VI tibial plateau fractureS. Methods： The clinical data of 42 cases ofSehatzker IV- VI tibial...Objective： To study the effect of internal fixation performed at different times on therapeutic outcomes of Schatzker IV-VI tibial plateau fractureS. Methods： The clinical data of 42 cases ofSehatzker IV- VI tibial plateau fractures treated in our department were analyzed retrospectively. Among these 42 patients, 21 re- ceived surgical treatment within 12 h after injury, （Group I）, the other 2 [ were first treated by traction or piaster fixation followed by a delayed internal fixation after soft tissue swell- i ing subsided （Group II）. The surgical time, comPlications, length of hospital stay, cost of hospitalization, and time for i fracture union, as well as functional recovery were analyzed and compared between the two groups. Results： After 10-28 months follow-up （mean 16.5 months）, except 5 cases who lost to follow-upl no differ-ences were found between the two groups regarding surgi- cal time, preoperative and postoperative complications, heal- ing time or the Hospital for Special Surgery （HSS） score at the end of follow-up, but significant differences were found in the length of hospital stay, cost of hospitalization and HSS score at 3 months after operation （P〈0.05）. Conclusion： Under certain conditions, early internal fixation for Schatzker IV-VI tibial plateau fracture is feasible, which can shorten the length of hospital stay, decrease the cost of hospitalization and promote early functional rehabilitation.展开更多
文摘目的研究老年胫骨内平台骨折在膝关节镜辅助下实施微创手术治疗效果。方法选取本院诊治的老年胫骨内平台骨折患者112例,按患者入院顺序随机分为对照组和观察组,各56例。对照组实施常规手术固定,观察组在膝关节镜辅助下实施微创手术,2组均于术后实施为期6个月随访复查。观察2组围术期指标、手术前及术后6个月膝关节功能及术后并发症。结果观察组切口长度为(3.53±0.81)cm,明显短于对照组的(9.24±2.33)cm;观察组手术时间为(1.71±0.82)h,明显短于对照组的(2.64±1.04)h;观察组骨折愈合时间为(12.33±3.47)周,明显短于对照组的(16.65±3.76)周;观察组住院时间(13.35±1.27)d,明显短于对照组的(18.91±2.51)d,差异均有统计学意义(P<0.001)。术后观察组美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS评分)为(90.52±5.54)分,与对照组的(91.64±5.33)分比较,差异无统计学意义(P>0.05);术后观察组美国膝关节协会评分(knee society knee score,KSS评分)为(93.37±5.21)分,与对照组的(90.02±5.14)分比较,差异无统计学意义(P>0.05)。观察组并发症发生率为10.71%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论膝关节镜辅助下的微创手术效果较好,可降低老年胫骨内平台骨折患者术后并发症发生率,同时缩短患者恢复时间,且术后膝关节功能恢复较好。
文摘Intraarticular nonunion of tibial plateau is rare. In the literature, only 9 patients were found to be treated for intraarticular tibial plateau nonunion and they got varying results. Internal fixation along with bone grafting was done as a standard treatment in all cases. We treated 4 different profile cases of intraarticular tibial plateau nonunion in our institution by 4 different methods. We treated these cases with plaster of paris cast, internal fixation along with bone graft, arthrodesis with K-nail and total knee replacement. Case 1 was treated with plaster of paris （POP） cast as the patient refused surgery. The fracture was united and the patient was fully satisfied with full range of motion despite valgus malalignment. Case 2 was managed with open reduction internal fixation along with bone grafting. Thepatient had a good union and got full range of motion at the knee joint. Case 3 was treated with total knee arthroplasty due to her old age and got satisfactory result. Case 4 was an infected nonunion. Arthrodesis was done and the patient could walk with full weight bearing independently. We conclude that internal fixation along with bone grafting may not be suitable in all cases of intraarticular nonunion of tibial plateau. Causes of nonunion, present condition and range of motion of the knee joint, as well as the age of patient should be all considered and the treatment should be individualised according to each patient＇s situation.
文摘Objective： To study the effect of internal fixation performed at different times on therapeutic outcomes of Schatzker IV-VI tibial plateau fractureS. Methods： The clinical data of 42 cases ofSehatzker IV- VI tibial plateau fractures treated in our department were analyzed retrospectively. Among these 42 patients, 21 re- ceived surgical treatment within 12 h after injury, （Group I）, the other 2 [ were first treated by traction or piaster fixation followed by a delayed internal fixation after soft tissue swell- i ing subsided （Group II）. The surgical time, comPlications, length of hospital stay, cost of hospitalization, and time for i fracture union, as well as functional recovery were analyzed and compared between the two groups. Results： After 10-28 months follow-up （mean 16.5 months）, except 5 cases who lost to follow-upl no differ-ences were found between the two groups regarding surgi- cal time, preoperative and postoperative complications, heal- ing time or the Hospital for Special Surgery （HSS） score at the end of follow-up, but significant differences were found in the length of hospital stay, cost of hospitalization and HSS score at 3 months after operation （P〈0.05）. Conclusion： Under certain conditions, early internal fixation for Schatzker IV-VI tibial plateau fracture is feasible, which can shorten the length of hospital stay, decrease the cost of hospitalization and promote early functional rehabilitation.
