膝关节镜辅助下微创手术与传统手术治疗胫骨平台骨折的临床疗效比较

Comparison of clinical effects of knee arthroscopy assisted minimally invasive surgery and conventional surgical treatment of tibial plateau fractures

摘要:

目的 分析膝关节镜辅助下手术治疗胫骨平台骨折的临床疗效，并对该治疗方法的特点进行探讨。 方法 采用前瞻性研究的方法将60 例患者随机分为观察组与对照组，每组各30 例。观察组采用膝关节镜辅助 下有限切开骨折复位内固定的方式进行治疗，对照组采用传统切开复位内固定的方法。其中合并半月板游离 缘破裂18 例，合并前交叉韧带胫侧止点撕脱骨折11 例，合并内侧副韧带断裂9 例。在手术结束后，观察两组 患者的手术时间、切口长度，并在手术后对两组患者随访1 年，根据美国特种外科医院评分（HSS）膝关节 功能标准对其疗效进行评定。结果 两组患者经过治疗后，观察组患者的手术时间为（81.6±21.7）min，明 显低于对照组患者的（109.7±31.6）min ；观察组患者的切口长度明显短于对照组患者的切口长度，两组比较 差异有统计学意义（P <0.05）。观察组手术后并发症发生率为3.3%，对照组手术后并发症发生率为20.0%，两 组比较差异有统计学意义（P <0.05）。在临床疗效上，观察组患者的优良率为96.7%，明显优于对照组患者的 60.0%，两组比较差异有统计学意义（P <0.05）。结论 采用膝关节镜辅助下手术治疗胫骨平台骨折，能够在 最大程度上提高患者的治愈率，降低并发症的概率，并且具有创伤小、复位直观和固定可靠等特点，值得临床 上进行推广。

Abstract:

Objective To analyze the clinical efficacy of arthroscopic assisted surgery for tibial plateau fractures and discuss the characteristics of the treatment. Methods 60 patients were randomly divided into observation group and control group, 30 cases in each. The observation group was treated by limited reduction and internal fixation with knee arthroscopy, while the control group was treated with traditional open reduction and internal fixation. Among them, there were 18 cases of rupture of the free edge of the meniscus, including 11 cases of avulsion fracture of the tibial ligament of the anterior cruciate ligament and 9 cases of the rupture of the medial collateral ligament. At the end of the operation, the operation time and incision length of the two groups were observed and the two groups were followed up for 1 year after operation. The curative effect was evaluated according to the HSS functional standard of knee joint. Results After treatment, the operation time in observation group was (81.6 ± 21.7) min, which wassignificantly lower than that in control group (109.7 ± 31.6) min; the cut length of the observation group is shorter than the control group, two sets of contrasting differences, P < 0.05, statistically significant. Observe the incidence of postoperative complications of the group is 3.3% in the control group incidence of complications after surgery for 20.0%, two sets of contrasting differences, P < 0.05; in terms of clinical, Observer Group of patients has a high rate of 96.7%, much better than the control group patients with 60.0%, two sets of contrasting differences, statistically significant, P < 0.05. Conclusion Arthroscopic assisted surgical treatment of tibial plateau fractures, to maximize patient cure rates, reduce the probability of complications and have a less traumatic, intuitive, reliable fixed reset features, and clinically to promote.