关节镜下胫骨平台手术与传统手术的治疗效果及术后恢复情况研究

Comparison of therapeutic effect and postoperative recovery of arthroscopy assisted percutaneous internal fixation and traditional surgery for tibial plateau fractures

摘要:

目的 比较经关节镜检查下的胫骨平台手术与传统手术的治疗效果及术后恢复情况。方法 采 用回顾性分析的方法，选取2012 年1 月-2015 年1 月山东省淄博市第一医院接受治疗的胫骨平台骨折的患者 178 例，根据不同的治疗方法分为两组，其中采用关节镜检查下的胫骨平台手术（关节镜组）99 例，采用传统 手术治疗（对照组）79 例。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 与对照组相比，关节镜组术中及术后出血量较少， 差异均具有统计学意义（P <0.05），手术时间与对照组相比差异无统计学意义。对患者进行18 ～ 24 个月随访， 关节镜组的HSS 评分更高，术后伤口愈合时间更短，并发症发生的情况更少，差异均具有统计学意义（P <0.05）。 结论 两种治疗方法都能达到良好的临床效果，但经关节镜检查的胫骨平台骨折术中出血量少，未增加患者 手术时间，愈合时间短，并发症发生较少，HSS 评分较高，能够减少患者痛苦，提高患者治疗。

Abstract:

Objective To compare the effectiveness of arthroscopy assisted percutaneous internal fixation and open reduction of traditional surgery for tibial plateau fractures. Methods Between January 2012 and January 2015, 178 patients with tibial plateau fractures were treated with arthroscopy assisted percutaneous internal fixation (arthroscopy group, n = 99), and control group (n = 79) with traditional surgery for the treatment of tibial plateau fractures. The operation time, fracture healing time, intraoperative and postoperative blood loss and complications were compared between the two groups. Knee function score and the range of motion were measured according to American Hospital for Special Surgery (HSS) score standard. Results Compared with control group, the amount of blood loss in arthroscopic group was less than that in control group (P < 0.05), and there was no significant difference in the operation time compared with control group. After 18~24 months follow-up, the HSS score of the arthroscopic group was higher, the wound healing time was shorter and the complication occurred less, the difference was statistically significant (P < 0.05). Conclusion The two treatment methods can achieve good clinical results, but after arthroscopic microscopic examination of the tibial plateau fractures with benefits such as: less blood loss, not increased the operation time, shorter healing time and less complications, higher HSS score while reduced the suffering of patients and improved the efficacy.