CAJ | 학술논문

目的：比较关节镜辅助复位与传统手术方式治疗胫骨平台骨折的临床效果。方法选取胫骨平台骨折（SchatzkerⅠ～Ⅳ型）患者75例，按数字表法随机分为关节镜组和传统手术组，比较两组术后并发症发生率、手术时间、切口长度、术中及术后出血量、住院时间以及临床功能优良率，观察两种手术方式的临床疗效和应用价值。结果关节镜组并发症发生率（2．70％）较传统手术组（21．3％）显著降低（χ2＝5．980，P ＝0.014）；关节镜组手术时间[（88．1±15．2）min]较传统手术组[（103．8±22．1）min]显著缩短（t ＝3．575，P ＝0．001）；关节镜组切口长度[（6．7±2．3）cm]较传统手术组[（10．8±2．7）cm]显著缩短（t ＝5．745，P ＝0.000）；关节镜组住院时间[（4．5±2．3）d]较传统手术组[（6．5±3．1）d]显著缩短（t ＝3．166，P ＝0．003）；关节镜组患者术中＋术后出血量[（145．2±43．0）mL]亦较传统手术组[（294．4±90．2）mL]显著减少（t ＝7.829，P ＝0．000）；关节镜组术后临床功能优良率（86．49％）较传统手术组（71．05％）显著提高（χ2＝3．723， P ＝0．039）。结论应用关节镜辅助下骨折复位内固定治疗胫骨平台骨折（SchatzkerⅠ～Ⅳ型），具有并发症发生率低、创伤小、手术时间短以及术后膝关节功能优良率高等优点，值得广泛推广。
목적：비교관절경보조복위여전통수술방식치료경골평태골절적림상효과。방법선취경골평태골절（SchatzkerⅠ～Ⅳ형）환자75례，안수자표법수궤분위관절경조화전통수술조，비교량조술후병발증발생솔、수술시간、절구장도、술중급술후출혈량、주원시간이급림상공능우량솔，관찰량충수술방식적림상료효화응용개치。결과관절경조병발증발생솔（2．70％）교전통수술조（21．3％）현저강저（χ2＝5．980，P ＝0.014）；관절경조수술시간[（88．1±15．2）min]교전통수술조[（103．8±22．1）min]현저축단（t ＝3．575，P ＝0．001）；관절경조절구장도[（6．7±2．3）cm]교전통수술조[（10．8±2．7）cm]현저축단（t ＝5．745，P ＝0.000）；관절경조주원시간[（4．5±2．3）d]교전통수술조[（6．5±3．1）d]현저축단（t ＝3．166，P ＝0．003）；관절경조환자술중＋술후출혈량[（145．2±43．0）mL]역교전통수술조[（294．4±90．2）mL]현저감소（t ＝7.829，P ＝0．000）；관절경조술후림상공능우량솔（86．49％）교전통수술조（71．05％）현저제고（χ2＝3．723， P ＝0．039）。결론응용관절경보조하골절복위내고정치료경골평태골절（SchatzkerⅠ～Ⅳ형），구유병발증발생솔저、창상소、수술시간단이급술후슬관절공능우량솔고등우점，치득엄범추엄。
Objective To compare the efficacy between arthroscopic assisted reduction and traditional opera-tion approach for the treatment of tibial plateau fractures.Methods 75 patients with tibial plateau fracture(SchatzkerⅠ -Ⅳ type)were recruited,which were randomly divided into the arthroscopic and traditional operation group according to different treatment methods.The clinical efficacy and value of arthroscopically assisted reduction was ana-lyzed and compared according to the incidence of postoperative complications,the operative time,incision length,blood loss,hospital stay,and clinical efficacy between the two groups.Results Compared with the data in the traditional operation group,the incidence of postoperative complications (2.70% vs.21.3%)was significantly lower(χ2 =5.980,P =0.014).The operative time[(88.1 ±15.2)min vs.(103.8 ±22.1)min]was significantly shorter(t =3.575,P =0.001).And the incision length[(6.7 ±2.3)cm vs.(10.8 ±2.7)cm)]declined greatly(t =5.745,P =0.000).The hospital stay time and blood loss were significantly lower than that of the traditional operation group[(4.5 ± 2.3)d vs.(6.5 ±3.1)d;(145.2 ±43.0)mL vs.(294.4 ±90.2)mL,respectively],and the differences were statisti-cally significant(t =3.166,P =0.003;t =7.829,P =0.000,respectively).The excellent rate of clinical features in arthroscopic group(86.49%)was higher than that of traditional operation group(71.05%),and the difference was statistically significant(χ2 =3.723,P =0.039).Conclusion Arthroscopic -assisted reduction has many features for the tibial plateau fractures (SchatzkerⅠ -Ⅳ type),such as lower incidence of postoperative complications,less trau-ma,shorter operative time,and better postoperative knee function and so on,so it is worthy of clinical application.