关节镜镜检下的牵引复位手术与传统开囊复位手术治疗外侧或单侧胫骨平台骨折的对比研究

Comparative study of unilateral or bilateral arthroscopic examination of traditional open surgery and drawed reset sac surgery tibial plateau fractures

摘要:

目的??比较经关节镜镜检下的胫骨平台手术与开囊复位手术的治疗效果及术后恢复。方法?选自2013年8月－2014年4月该院接受治疗的胫骨平台骨折的患者78例，据随机数字表法随机分为A组和B组，每组患者各39例。A组采用关节镜下牵引复位手术治疗，B组采用传统开囊复位手术。比较两组的手术时间、术中出血量、愈合时间以及术后切口并发症；根据美国特种外科医院（HSS）评分标准对术后膝关节功能评分。结果?A组手术时间短于B组，术中及术后出血量少于B组，伤口损伤面积少于B组，伤口愈合时间快于B组，HSS评分高于B组，差异均有统计学意义（P <0.05）；两组随访时间比较差异无统计学意义（P >0.05）；A组术后并发症发生率低于B组，差异有统计学意义（P <0.05）。结论?两种治疗方法都能达到良好的临床效果，但经关节镜镜检的胫骨平台骨折具有手术时间短、术中出血量少、愈合时间短、并发症发生较少和HSS评分较高等优点，减少患者痛苦，提高患者治疗。

Abstract:

Objective?To compare the effectiveness of arthroscopy assisted percutaneous internal fixation and open reduction and traditional surgery tibial plateau fractures.?Methods?From August 2013 to April 2014, 78 patients with tibial plateau fractures according to random number table were divided into group A and group B, 39 cases in each. A group of traction using arthroscopic surgery, group B with traditional open bag reduction surgery.?Results?The operation time, intraoperative and postoperative bleeding less and wound lesion area was shorter and less in group A than that in group B; while the healing time and HSS score was faster and higher than that in group B. The difference was statistically significant (P < 0.05); the follow-up time of the two groups show no significant difference (P > 0.05); postoperative complication rate in group A was lower than that in group B, and there is significant difference (P < 0.05).?Conclusion?Both treatment methods can achieve good clinical results, but arthroscopically assisted treatment of tibial plateau fractures reset shorter operative time, less blood loss, healing time is shorter, less complications, but higher HSS score, etc., which reduced the suffering of patients and improved the outcome.