关节镜辅助下经皮钢板内固定治疗胫骨 平台骨折27例疗效观察

Arthroscopic assisted percutaneous plate fixation in the treatment of tibial plateau fractures: a study of 27 cases

摘要:

目的 探讨关节镜辅助下结合微创技术治疗胫骨平台骨折手术效果。方法 2007年7月～2011年12月，收治27例胫骨平台骨折患者，按Schatzker分型：Ⅰ型：10例；Ⅱ型：9例；Ⅲ型：3例；Ⅳ型：3例；Ⅴ型：2例；合并半月板损伤6例，前交叉韧带损伤3例。后交叉韧带损伤1例，内侧副韧带损伤Ⅲ度7例；所有病例均在关节镜辅助下进行复位和不同形式的内固定。结果 术后患者切口均Ⅰ期愈合，患者均获随访，随访时间6～26个月，平均12个月。骨折均达骨性愈合，愈合时间3～5个月，平均3.5个月；按照Merchant等的评分标准：优18例，良7例，中1例，差1例。优良率为92%。结论 关节镜辅助下结合微创技术治疗胫骨平台骨折具有复位准确、损伤小、恢复快及功能佳等优点。

Abstract:

【Objective】 To explore arthroscopically assisted combined with minimally invasive technique in the treatment of tibial plateau fracture operation effect. 【Methods】 From 2007 July~2011 December, 27 cases of tibial plateau fracture patients, according to Schatzker classification: type I:10 cases; II: 9 cases; Ⅲ:3 cases; IV: 3 cases; and type V: 2 cases, combined meniscal plate injury in 6 cases, front fork ligament injury in 3 cases, posterior cruciate ligament injury in1case, injury of the medial collateral ligament Ⅲ degree 7 cases; All cases were in arthroscopic reduction and different forms of internal fixation. 【Results】 Postoperative patients incisions were healed, patients were followed up for 6~26 months, average 12 months. Fractures were healed, healing time ranged from 3 to 5 months, mean 3.5 months; according to the Merchant scoring system: this group was excellent in 18 cases, good in 7 cases, in 1 cases, and poor in 1 case. The excellent and good rate was 92%. 【Conclusion】 Arthroscopic combined with minimally invasive techniques in the treatment of tibial plateau fracture, not only can timely detect and treat intra-articular injuries , but also can make fracture and reduction of articular surface more accurate; This method has some advantages, such as little injury, quick recovery, excellent prognosis.