中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
4期
54-57
,共4页
胫骨平台骨折%关节镜%微创性%锁定钢板%内固定%切口复位
脛骨平檯骨摺%關節鏡%微創性%鎖定鋼闆%內固定%切口複位
경골평태골절%관절경%미창성%쇄정강판%내고정%절구복위
Tibial plateau fractures%Arthroscopy%Minimally invasive%Locking plate%Fixation%Incision reset
目的 比较关节镜下经皮锁定钢板内固定术与开放性锁定钢板内固定术治疗胫骨平台骨折的疗效.方法 选取需要手术治疗的胫骨平台骨折(Schatzker Ⅰ～Ⅳ型)患者72例,按照数字表法随机分为两组:微创组(37例)采用关节镜下经皮微创锁定钢板内固定;对照组(35例)采用开放性切开复位锁定钢板内固定术.比较两组患者切口长度、术中出血量、手术时间、骨折愈合时间、美国特种外科医院(HSS)评分、并发症及膝关节功能优良率.结果 微创组的切口长度、骨折愈合时间明显短于对照组(P均＜0.01),术中出血量明显少于对照组(P＜0.01),HSS评分明显高于对照组(P＜0.05),并发症发生率明显低于对照组(x2=4.8572,P＜0.05),膝关节功能优良率明显高于对照组(x2 =5.7312,P＜0.05),差异均有统计学意义.结论 关节镜下经皮微创锁定钢板内固定术治疗Schatzker Ⅰ ～Ⅳ型胫骨平台骨折具有创伤小、操作简单、固定可靠、骨折愈合时间短、膝关节功能恢复快、并发症少、能同时发现和处理关节内并发症等优点,效果较切开复位更有优势.
目的 比較關節鏡下經皮鎖定鋼闆內固定術與開放性鎖定鋼闆內固定術治療脛骨平檯骨摺的療效.方法 選取需要手術治療的脛骨平檯骨摺(Schatzker Ⅰ～Ⅳ型)患者72例,按照數字錶法隨機分為兩組:微創組(37例)採用關節鏡下經皮微創鎖定鋼闆內固定;對照組(35例)採用開放性切開複位鎖定鋼闆內固定術.比較兩組患者切口長度、術中齣血量、手術時間、骨摺愈閤時間、美國特種外科醫院(HSS)評分、併髮癥及膝關節功能優良率.結果 微創組的切口長度、骨摺愈閤時間明顯短于對照組(P均＜0.01),術中齣血量明顯少于對照組(P＜0.01),HSS評分明顯高于對照組(P＜0.05),併髮癥髮生率明顯低于對照組(x2=4.8572,P＜0.05),膝關節功能優良率明顯高于對照組(x2 =5.7312,P＜0.05),差異均有統計學意義.結論 關節鏡下經皮微創鎖定鋼闆內固定術治療Schatzker Ⅰ ～Ⅳ型脛骨平檯骨摺具有創傷小、操作簡單、固定可靠、骨摺愈閤時間短、膝關節功能恢複快、併髮癥少、能同時髮現和處理關節內併髮癥等優點,效果較切開複位更有優勢.
목적 비교관절경하경피쇄정강판내고정술여개방성쇄정강판내고정술치료경골평태골절적료효.방법 선취수요수술치료적경골평태골절(Schatzker Ⅰ～Ⅳ형)환자72례,안조수자표법수궤분위량조:미창조(37례)채용관절경하경피미창쇄정강판내고정;대조조(35례)채용개방성절개복위쇄정강판내고정술.비교량조환자절구장도、술중출혈량、수술시간、골절유합시간、미국특충외과의원(HSS)평분、병발증급슬관절공능우량솔.결과 미창조적절구장도、골절유합시간명현단우대조조(P균＜0.01),술중출혈량명현소우대조조(P＜0.01),HSS평분명현고우대조조(P＜0.05),병발증발생솔명현저우대조조(x2=4.8572,P＜0.05),슬관절공능우량솔명현고우대조조(x2 =5.7312,P＜0.05),차이균유통계학의의.결론 관절경하경피미창쇄정강판내고정술치료Schatzker Ⅰ ～Ⅳ형경골평태골절구유창상소、조작간단、고정가고、골절유합시간단、슬관절공능회복쾌、병발증소、능동시발현화처리관절내병발증등우점,효과교절개복위경유우세.
Objective To compare the effect of arthroscopic percutaneous locking plate fixation and open locking plate fixation on therapy of tibial plateau fractures.Methods Seventy-two cases of tibial plateau fractures(type Schatzker Ⅰ-Ⅳ) required surgical treatment were randomly divided into two groups in accordance with the number table:patients in minimally invasive group (37 cases) were treated by arthroscopic percutaneous locking plate fixation; patients in control group (35 cases) were treated by open locking plate fixation.The incision length,surgical blood loss,operative time,fracture healing time,hospital for special surgery (HSS) score,complications and excellent rate of knee function between the two groups were compared.Results The incision length,fracture healing time of the minimally invasive group were significantly shorter than those in the control group(all P ＜ 0.01) ; The surgical blood loss of the minimally invasive group was significantly less than that in the control group (P ＜0.01) ; The HSS score of the minimally invasive group was significantly higher than that in the control group (P ＜ 0.05) ; The complication rate of the minimally invasive group was significantly lower than that in the control group (x2 =4.8572,P ＜ 0.05) ; The excellent rate of knee function of the minimally invasive group was significantly higher than that in the control group(x2 =5.7312,P ＜0.05).Conclusions It has less trauma,simple operation,reliable fixation,short fracture healing time,faster recovery of knee function,fewer complications that arthroscopic percutaneous locking plate fixation for therapy of tibial plateau fractures (type Schatzker Ⅰ-Ⅳ),simultaneous detection and treatment of intra-articular complications,and it has advantage in effect than open reduction.
