胫骨平台骨折合并交叉韧带损伤患者行关节镜治疗的疗效及安全性分析

Efficacy and safety of arthroscopy in patients with tibia plateau fracture complicated with cruciate ligament injury

摘要:

目的 分析探讨胫骨平台骨折合并交叉韧带损伤患者行关节镜治疗的临床疗效及安全性。方法 选取2016年7月－2018年7月该院骨外科收治的69例胫骨平台骨折合并交叉韧带损伤患者作为研究对象，采用随机数字表法将其分为关节镜组（n = 35）和常规组（n = 34）。常规组予以常规切开复位内固定术治疗，关节镜组则予以关节镜辅助下经皮复位内固定微创治疗。统计两组患者的手术时间、切口长度、术中出血量、住院时间及愈合时间等一般情况，评估两组患者手术治疗后的膝关节功能恢复情况和临床疗效，并统计两组手术并发症情况。结果 关节镜组术中出血量少于常规组，手术时间、住院时间、愈合时间及切口长度明显短于常规组，差异均有统计学意义（P < 0.05）。治疗后，两组患者膝关节功能各项评分及总分均高于治疗前，减分项目则低于治疗前（P < 0.05），且关节镜组膝关节功能各项评分及总分均高于常规组，减分项目低于常规组（P < 0.05）。关节镜组治疗总有效率为91.43%，高于常规组70.59%，差异有统计学意义（P < 0.05）。关节镜组并发症总发生率为2.86%，低于常规组23.53%，差异有统计学意义（P < 0.05）。结论 胫骨平台骨折合并交叉韧带损伤患者行关节镜治疗，手术创伤小，手术时间和恢复时间短，膝关节功能恢复更佳，相关并发症少，安全性好。

Abstract:

Objective To analyze the clinical efficacy and safety of arthroscopy in patients with tibia plateau fracture complicated with cruciate ligament injury.Methods From July 2016 to July 2018, 69 patients with tibia plateau fracture complicated with cruciate ligament injury were selected as the research subjects. They were randomly divided into arthroscopy group (n = 35) and routine group (n = 34). The routine group was treated with conventional open reduction and internal fixation, while the arthroscopy group was treated with minimally invasive reduction and internal fixation assisted by arthroscopy. The operation time, incision length, intraoperative blood loss, hospitalization time and healing time were statistically compared between the two groups, and the functional recovery and clinical efficacy of knee joint between the two groups were evaluated and compared. The complications of the two groups were counted.Results The amount of intraoperative bleeding in arthroscopy group was less than that in routine group. The hospitalization time, healing time and incision length in arthroscopy group were significantly shorter than those in routine group (P < 0.05). After treatment, the scores and total scores of knee joint function in both groups were higher than those before treatment, and the score items were lower than those before treatment (P < 0.05). The score and total score of knee joint function in arthroscopy group were higher than those in routine group, deduction items are lower than that in regular group (P < 0.05). The total effective rate of arthroscopy group was 91.43%, which was significantly higher than that of routine group (70.59%) (P < 0.05). The total incidence of complications in arthroscopy group was 2.86%, which was lower than that in routine group (23.53%) (P < 0.05).Conclusion The patients with tibia plateau fracture complicated with cruciate ligament injury are treated by arthroscopy with less trauma, shorter operation time and recovery time, better functional recovery of knee joint, fewer related complications and better safety.