膝关节镜辅助下内固定治疗后外侧胫骨平台骨折的疗效分析

摘要

Objective To study the efficacy of fixation with knee arthroscopy as adjuvant therapy for lateral tibial plateau fracture. Methods 72 cases with lateral tibial plateau fracture of our hospital from September 2011 to September 2014 were divided into experimental group (36 cases) and control group (36 cases), according to different operation method, the experimental group using arthroscopic, while the control group using traditional incision surgery. Then the incision length, operative time, hospital stay, wound healing, bone healing time were compared. Complications, knee function and reduction of the fracture were compared. Results The incision length of experimental group was significantly lower than the control group, the difference was statistically significant (P <0.05). Operative time, hospital stay, wound healing time, the bone healing time were significantly lower than the control group, the differences were statistically significant (P < 0.05). Delay healing, joint stiffness and traumatic arthritis were significantly lower than the control group, the differences were statistically significant (P < 0.05). RASMUSSEN function score and radiographic scores in the experimental group were significantly higher than the control group, the differences were statistically significant (P < 0.05). Conclusion Fixation with knee arthroscopy as adjuvant therapy for lateral tibial plateau fracture has advantages of smaller incision, shorter operative time and hospital stay and healing time, lower complication rate while better reduction of the fracture and function than conventional methods.%目的：研究膝关节镜辅助下内固定治疗后外侧胫骨平台骨折的疗效。方法收集2011年9月-2014年9月该院骨科收治的胫骨平台后外侧骨折72例，随机将入组患者分为实验组（36例）和对照组（36例），实验组采用膝关节镜辅助下内固定治疗，对照组采用传统切开手术治疗，比较两组切口长度、手术时间、住院时间、切口愈合时间和骨愈合时间等一般特征差异；比较两组患者并发症发生情况差异；比较两组膝关节功能及骨折复位情况差异。结果实验组切口长度明显短于对照组，差异有统计学意义（P <0.05）。实验组手术时间、住院时间、切口愈合时间和骨愈合时间均明显低于对照组，差异均有统计学意义（均 P <0.05）。术后实验组近、远期并发症发生率均明显低于对照组，差异均有统计学意义（均 P <0.05）。RASMUSSEN 功能评分和放射学评分实验组优良均明显高于对照组，差异均有统计学意义（均P <0.05）。结论关节镜辅助下内固定治疗后外侧胫骨平台骨折较统切开手术，切口小，手术时间、住院时间和愈合时间短，并发症发生率低，复位效果好，膝关节功能恢复好，可作为后外侧胫骨平台治疗的常规方法。