CAJ | 학술논문

目的：探讨关节镜监视下解剖钢板治疗胫骨平台骨折的临床疗效。方法2012年2月～2014年1月，采用AO解剖锁定钢板在关节镜监视下治疗20名胫骨平台骨折患者。男性12例，女性8例；年龄19～53岁，平均33．8岁。骨折类型：按Schatzker分型：Ⅴ型12例，Ⅵ型8例。受伤至手术时间为2～15 d（平均4.3 d）。通过对照研究，研究在手术时间、软组织合并伤、早期术后并发症、内固定松动、膝关节功能（HISS评分）等方面两种手术方法是否存在差异。结果关节镜组术后无切口愈合不良、感染、骨筋膜综合征等并发症发生。患者均获随访，随访时间12～24个月，平均12个月。骨折愈合时间2.5～4.5个月，平均3.4个月。采用SPSS统计软件分析，认为关节镜组在术中失血量、术后功能评分及并发症发生方面均优于传统手术组，有显著差异，但在手术切口愈合时间、骨痂生长方面两组无显著差异。结论关节镜监视下解剖钢板治疗胫骨平台骨折，能直视下复位，有切口小，出血少，并发症少，功能优良等特点，还可同时治疗关节内合并损伤，是一种治疗胫骨平台重度粉碎骨折安全、有效的微创治疗方法。
목적：탐토관절경감시하해부강판치료경골평태골절적림상료효。방법2012년2월～2014년1월，채용AO해부쇄정강판재관절경감시하치료20명경골평태골절환자。남성12례，녀성8례；년령19～53세，평균33．8세。골절류형：안Schatzker분형：Ⅴ형12례，Ⅵ형8례。수상지수술시간위2～15 d（평균4.3 d）。통과대조연구，연구재수술시간、연조직합병상、조기술후병발증、내고정송동、슬관절공능（HISS평분）등방면량충수술방법시부존재차이。결과관절경조술후무절구유합불량、감염、골근막종합정등병발증발생。환자균획수방，수방시간12～24개월，평균12개월。골절유합시간2.5～4.5개월，평균3.4개월。채용SPSS통계연건분석，인위관절경조재술중실혈량、술후공능평분급병발증발생방면균우우전통수술조，유현저차이，단재수술절구유합시간、골가생장방면량조무현저차이。결론관절경감시하해부강판치료경골평태골절，능직시하복위，유절구소，출혈소，병발증소，공능우량등특점，환가동시치료관절내합병손상，시일충치료경골평태중도분쇄골절안전、유효적미창치료방법。
Objective To explore the clinical effect of arthroscopic treatment of tibial plateau fractures with anatomical plate.Methods from 2012 to 2014 year February January, using arthroscope used AO for treating 20 cases of tibial plateau fracture with anatomical locking plate. Male 12 cases, female 8 cases; age 19 ~ 53 years, average 33.8 years old.According to Schatzker classification: 12 cases of type V, 8 cases of type VI. The time between injury and operation was 2 to 15d (mean 4.3d). Through comparative study, comparing the two treatment methods in operation time, soft tissue injury, early postoperative complications, internal fixation failure, knee joint function (HISS score) difference index.Results Without the poor wound healing, infection, bone compartment syndromresults after operation. The patients were folowed up, the folow-up time ranged from 12 to 24 months, average 12 months. The healing time ranged from 2.5 to 4.5 months, fracture, with an average of 3.4 months. Analysis by SPSS19.0 statistical software, that the function of blood loss in operation group, operation after the score and complications were better than the control group, there was significant difference in the operation, but the wound healing time, calus growth has no significant difference between the two groups. With open reduction, fracture with anatomical plate for the treatment of tibial plateau.Conclusion arthroscopic smal incision, less bleeding, fewer complications, characteristics and good functional recovery, can also be used for treatment of associated intra-articular injuries, is a minimaly invasive treatment method for the treatment of tibial plateau of severe comminuted fractures of safe, feasible.