| 摘要: |
| 目的探究关节镜下经皮内固定治疗闭合性SchatzkerⅡ～Ⅲ型胫骨平台骨折合并半月板损伤的近远期临床治疗效果。方法选取闭合性SchatzkerⅡ～Ⅲ型胫骨平台骨折合并半月板损伤患者64例，采用切开复位内固定治疗（传统组）和关节镜下经皮内固定治疗（关节镜组）各32例，详细记录两组患者的手术时长、术中出血量、切口长度、术后制动时间、骨折愈合时间、住院时间，术后6个月及术后3年的膝关节功能、复位情况、不良反应和骨性关节炎增级情况，比较两组患者的近远期疗效。结果近期疗效比较中，传统组患者术中出血量、切口长度、术后制动时间及不良反应发生率等均明显高于关节镜组，手术时长明显低于关节镜组（均P＜0.05）；两组患者术后6个月的膝关节功能及膝关节复位情况均良好，两组比较差异均无统计学意义（均P＞0.05）。远期疗效比较中，传统组患者术后3年的膝关节功能及膝关节复位情况均明显低于关节镜组，骨性关节炎Ahlback分级增加值明显高于关节镜组（均P＜0.05）。结论对于闭合性SchatzkerⅡ~Ⅲ型胫骨平台骨折合并半月板损伤患者采用关节镜下经皮内固定治疗能够有效减少手术创伤和术中出血量，合并处理关节腔内的其他损伤，降低手术感染风险，促进患者膝关节和半月板的功能恢复，远期膝关节功能恢复效果更加显著。 |
| 关键词: 胫骨平台骨折 内固定术 关节镜 |
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| Arthroscopic percutaneous internal fixation for tibil plateau fractures with meniscorhexis |
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XING Haixiang, SHEN Jianming, SHAN Guanxin
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Shaoxing Central Hospital
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| Abstract: |
| Objective To evaluate the clinical outcome of arthroscopic assisted percutaneous internal fixation for the closed schatzker II-III plateau fractures with meniscorhexis. Methods Selected 64 cases of closed Schatzker II-III tibial plateau fracture combined with meniscorhexis in our hospital from February 2010 to January 2013, randomly divided into traditional group and arthroscope group, each group of 32 cases. Recorded the operation time, bleeding amount, incision length, braking time, fracture healing time, hospitalization time, the knee joint function, reduction quality and so on, compared with short and long term curative effects of two groups. Results Comparison of short-term therapeutic effects, the bleeding amount, incision length, braking time, incidence of adverse reactions in the traditional group were significantly higher than arthroscope group, and the
operation length was significantly lower (all P＜0.05). The knee function and replacement after operation six months of two groups
were no significant differences (all P ＞0.05). Comparison of long-term therapeutic effects, follow up for three years the traditional group knee function and reduction quality were significantly lower than the arthroscope group, Ahlback grade of osteoarthritis increased values were significantly higher (all P ＜0.05). Conclusion For the Schatzker II-III tibial plateau fracture with meniscorhexis patients using arthroscopically assisted percutaneous fixation can reduce the surgical trauma, bleeding and infection, combined treatment of other injuries, promote the functional recovery, long-term therapeutic effects were remarkable. |
| Key words: Tibial plateau fractures Internal fixation Arthroscopic |
