膝關節鏡輔助復位鎖定鋼板內固定術治療脛骨平臺骨折的臨床價值

楊曉光

[摘要] 目的 探討膝關節鏡輔助復位鎖定鋼板內固定術治療脛骨平臺骨折的臨床價值。 方法 回顧性選取克孜勒蘇柯爾克孜自治州人民醫院骨科2018年12月至2020年6月收治的92例脛骨平臺骨折患者，根據治療方式分為常規組與微創組，每組各46例，常規組采用切開復位鎖定金屬接骨鋼板內固定術治療，微創組則采用膝關節鏡輔助復位鎖定金屬接骨鋼板內固定術治療，比較兩組手術用時、術中失血量、術后引流量、術前與術后2周膝關節功能（HSS）評分，并評價兩組治療后臨床療效;術后隨訪6個月，比較兩組并發癥發生情況。 結果 微創組手術用時、術中出血量及術后引流量均少于常規組，差異有統計學意義（P<0.05）;治療前兩組HSS評分比較，差異無統計學意義（P>0.05），治療后2周微創組HSS評分為（90.69±2.15）分，高于常規組的（78.53±3.82）分，差異有統計學意義（P<0.05）;微創組臨床優良率（93.48%）高于常規組（73.91%）;術后隨訪6個月，微創組并發生發生率（2.17%）低于常規組（13.04%）。 結論 膝關節鏡輔助復位鎖定金屬接骨鋼板內固定術治療脛骨平臺骨折臨床療效顯著，可有效縮短手術用時、減少失血量，有利于膝關節功能的恢復，具有較高的臨床應用價值。

[關鍵詞] 膝關節鏡;脛骨平臺骨折;鎖定鋼板內固定術;臨床療效

[中圖分類號] R683.4? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）21-0062-03

Clinical value of knee arthroscopy assisted reduction and locking plate internal fixation in the treatment of tibial plateau fracture

YANG Xiaoguang

Department of Orthopedics， People′s Hospital of Kizilsu Kirghiz Autonomous Prefecture in Xinjiang Uygur Autonomous Region， Kizilsu Kirghiz? ?845350， China

[Abstract] Objective To explore the clinical value of knee arthroscopy assisted reduction and locking plate internal fixation in the treatment of tibial plateau fracture. Methods A total of 92 patients with tibial plateau fractures admitted to and treated in the Department of Orthopedics of People′s Hospital of Kizilsu Kirghiz Autonomous Prefecture from December 2018 to June 2020 were retrospectively selected. According to the difference of treatment methods， they were divided into the conventional group（n=46） and the minimally invasive group，each groups has 46 cases. The conventional group was treated with open reduction and locking metal plate internal fixation，while the minimally invasive group was treated with knee arthroscopy assisted reduction and locking metal plate internal fixation. The operation duration， intraoperative hemorrhage volume，postoperative drainage volume， knee joint function （hospital for special surgery， HSS） scores before and 2 weeks after operation were compared between the two groups.The clinical efficacies of the two groups were evaluated. After operation， the patients were followed up for 6 months， and the incidences of complications were compared between the two groups. Results The operation duration， intraoperative hemorrhage volume and postoperative drainage volume of the minimally invasive group were all less than those of the conventional group， with statistically significant differences（P<0.05）. Before treatment， there was no statistically significant difference in HSS scores between two groups （P>0.05）. After 2 weeks of treatment， the HSS score of the minimally invasive group was （90.69±2.15）points， which was higher than （78.53±3.82） points of the conventional group， with statistically significant difference（P<0.05）. The excellent and good rate of the minimally invasive group was 93.48%， which was higher than 73.91% of the conventional group. After 6 months of follow-up， the incidence of complications in the minimally invasive group was 2.17%， which was lower than 13.04% in the conventional group. Conclusion Arthroscopic assisted reduction and locking metal plate internal fixation in the treatment of tibial plateau fractures has a significant clinical efficacy， which can effectively shorten the operation duration， reduce hemorrhage， and is conducive to the recovery of knee joint function. Therefore， it has higher clinical application value.