CAJ | 학술논문

目的探讨关节镜辅助下手术治疗Schatzker Ⅰ～Ⅳ型胫骨平台骨折的疗效.方法回顾性分析2002年10月至2009年10月关节镜辅助下手术治疗且获得随访的26例胫骨平台骨折患者资料,男15例,女11例;年龄24～68岁,平均43.6岁.骨折按Schatzker分型:Ⅰ型3例,Ⅱ型8例,Ⅲ型9例,Ⅳ型6例.关节镜辅助下采用撬拨和推顶的方法使胫骨平台骨折复位,骨缺损处用自体骨或同种异体骨植骨并采用拉力螺钉或支撑钢板固定.结果本组26例患者平均手术时间为92.6 min(60～120 min),骨折复位满意率为100%,术后创伤反应轻,无局部感染,切口愈合良好,无血管、神经损伤等严重并发症发生.26例患者术后获10～24个月(平均14.6个月)随访.26例患者骨折均获愈合,愈合时间为12～24周,平均16周.按Rasmussen膝关节功能分级系统评定疗效:优16例,良9例,中1例,优良率为96.2%.结论关节镜辅助下手术治疗Schatzker Ⅰ～Ⅳ型胫骨平台骨折具有创伤小、骨折复位满意、术后反应轻、骨折愈合良好及功能恢复快等优点.
목적 탐토관절경보조하수술치료Schatzker Ⅰ～Ⅳ형경골평태골절적료효.방법 회고성분석2002년10월지2009년10월관절경보조하수술치료차획득수방적26례경골평태골절환자자료,남15례,녀11례;년령24～68세,평균43.6세.골절안Schatzker분형:Ⅰ형3례,Ⅱ형8례,Ⅲ형9례,Ⅳ형6례.관절경보조하채용효발화추정적방법사경골평태골절복위,골결손처용자체골혹동충이체골식골병채용랍력라정혹지탱강판고정.결과 본조26례환자평균수술시간위92.6 min(60～120 min),골절복위만의솔위100%,술후창상반응경,무국부감염,절구유합량호,무혈관、신경손상등엄중병발증발생.26례환자술후획10～24개월(평균14.6개월)수방.26례환자골절균획유합,유합시간위12～24주,평균16주.안Rasmussen슬관절공능분급계통평정료효:우16례,량9례,중1례,우량솔위96.2%.결론 관절경보조하수술치료Schatzker Ⅰ～Ⅳ형경골평태골절구유창상소、골절복위만의、술후반응경、골절유합량호급공능회복쾌등우점.
Objective To report outcomes of arthroscopically assisted surgery for tibial plateau fractures of Schatzker types Ⅰ-Ⅳ. Methods From October 2002 to October 2009, 26 patients with tibial plateau fracture were treated with arthroscopically assisted surgery at our department.They were 15 males and 11 females, aged from 24 to 68 years (average, 43.6 years).Accordingto Schatzker classification, 3 cases were of type Ⅰ, 8 of type Ⅱ, 9 of type Ⅲ and 6 of type Ⅳ.Fracture segments of the tibial plateau were reduced under arthroscopy, and bone defects were filled with autografts or allografts before fixation with compression lag screws or buttress plates.Results The mean operation time was 92.6 minutes (from 60 to 120 minutes) .The satisfactory reduction rate was 100%.Postoperative traumatic reactions were slight,without local infection.Incisions healed well, without serious vascular or neural complications.All the 26 patients were followed up for an average of 14.6 months (from 10 to 24 months).All the fractures healed well after 12 to 24 weeks (average, 16 weeks).According to the Rasmussen scoring for knee function, 16 cases were excellent, 9 good and one was fair, with an excellent-to-good rate of 96.2%.Conclusion In treatment of tibial plateau fractures of Schatzker types Ⅰ-Ⅳ, arthroscopically assisted surgery has advantages of satisfactory reduction, limited operative invasion, mild postoperative reaction, fine bone healing and fast functional recovery.