关节镜辅助下锁定空心螺钉固定术对胫骨平台骨折患者膝关节功能和疼痛因子的影响

Impact of arthroscopic assisted locking hollow screw fixation on knee joint function and pain factors in patients with tibial plateau fractures

摘要:

目的 探讨关节镜辅助下锁定空心螺钉固定术对胫骨平台骨折患者膝关节功能和疼痛因子的影响。方法 选取2021年6月－2023年6月该院收治的胫骨平台骨折患者113例，依据不同手术方法，将患者分为关节镜组（57例）和传统组（56例）。关节镜组采用关节镜辅助下锁定空心螺钉固定术治疗，传统组采用切开复位内固定术治疗。比较两组患者手术情况、术后恢复情况、并发症发生率、术前和术后24 h疼痛因子水平变化情况、术前和术后6个月膝关节功能，以及术后6个月膝关节活动度变化。结果 关节镜组手术时间明显短于传统组，术中出血量明显少于传统组，差异均有统计学意义（P < 0.05）；两组患者术后24 h血清5-羟色胺（5-HT）、P物质（SP）和前列腺素E2（PGE2）水平明显高于术前，但关节镜组明显低于传统组，差异均有统计学意义（P < 0.05）；关节镜组术后下床活动时间、住院时间、负重时间和骨折愈合时间明显短于传统组，差异均有统计学意义（P < 0.05）；两组患者术后6个月美国膝关节协会评分（KSS）临床评分、KSS功能评分和美国特种外科医院膝关节评分（HSS）比较，差异均无统计学意义（P > 0.05）；关节镜组术后6个月膝关节伸直度和屈曲度明显大于传统组，差异均有统计学意义（P < 0.05）；关节镜组术后切口感染明显少于传统组，差异有统计学意义（P < 0.05）。结论 关节镜辅助下锁定空心螺钉固定术治疗胫骨平台骨折，疗效较好，可明显改善患者膝关节功能，抑制疼痛因子释放，值得临床推广应用。

Abstract:

Objective To investigate the impact of arthroscopic assisted locking hollow screw fixation on knee joint function and pain factors in patients with tibial plateau fractures.Method 113 patients with tibial plateau fractures from June 2021 to June 2023 were selected. According to different surgical methods, the patients were divided into arthroscopic group (57 cases) and traditional group (56 cases). The arthroscopic group was treated with arthroscopic assisted locking hollow screw fixation, while the traditional group was treated with open reduction and internal fixation. Compare the surgical status, postoperative recovery, and incidence of complications between two groups of patients, as well as the changes in pain factor levels before and after 24 hours of surgery, knee joint function before and 6 months after surgery, and changes in knee joint range of motion 6 months after surgery.Results The results showed that the arthroscopic group had significantly shorter surgical time and less intraoperative bleeding compared to the traditional group, with statistically significant differences (P < 0.05); The serum levels of 5-hydroxytryptamine (5-HT), substance P (SP), and prostaglandin E2 (PGE2) were significantly higher in both groups of patients 24 hours after surgery than those before surgery, but the arthroscopic group was significantly lower than that in traditional group, and the differences were statistically significant (P < 0.05); The arthroscopic group had significantly shorter postoperative mobilization time, hospitalization time, weight-bearing time, and fracture healing time compared to the traditional group, and the differences were statistically significant (P < 0.05); There was no statistically significant difference in Knee Society score (KSS) clinical score, KSS functional score, and hospital for special surgery knee score (HSS) between the two groups of patients 6 months after surgery (P > 0.05); The knee joint extension and flexion in the arthroscopic group were significantly greater than those in the traditional group 6 months after surgery, and the differences were statistically significant (P < 0.05); The postoperative incision infection in the arthroscopic group was significantly less than that in the traditional group, and the difference was statistically significant (P < 0.05).Conclusion Arthroscopic assisted locking hollow screw fixation is effective in treating tibial plateau fractures, significantly improving knee joint function and inhibiting pain factor release. It is worthy of clinical promotion and application.