摘要
[目的]介绍关节镜辅助下微创撬拨复位治疗SchatzkerⅠ-Ⅳ型胫骨平台骨折的方法及近期疗效。[方法]2014年5月～2016年11月收治的39例胫骨平台骨折患者,按Schatzker分类法:Ⅰ型5例、Ⅱ型19例、Ⅲ型12例、Ⅳ型3例。采用关节镜下开窗撬拨复位、取自体髂骨或同种异体骨植骨、经皮螺钉或接骨板内固定,半月板损伤同时处理。依据HSS评分评定临床效果。[结果] 39例均顺利手术,无严重并发症。X线片复查提示骨折愈合时间为3～6个月。末次随访时依据膝关节HSS评分评级:优24例,良9例,可6例,优良率84.60%,膝关节功能活动良好。[结论]关节镜辅助下微创撬拨复位治疗Schatzker I-IV型胫骨平台骨折效果良好,具有创伤小、恢复快、并发症少的优势。
[Objective] To introduce the surgical technique and early outcomes of arthrescopy-assistedreduction and internal fixation for treatment of Schatzker type Ⅰ-Ⅳ tibial plateau fractures. [Methods] From May 2014 to November 2016, 39 patients underwent arthroscopy-assisted operation in our department for tibial plateau fractures that included Schatzker type Ⅰ in 5 cases, type Ⅱin 19, typeⅢ in 12 and type Ⅳ in 3. The peking reduction combined with autogenous iliac bone graft or bone allograft by a fenestration of proximal tibia, and fixation with screw and plate were conducted under arthroscopic vision. The accompanied meniscus injuries were simultaneously treated. The clinical outcomes were graded based on HSS scores. [Results] All 39 patients had operation conducted successfully without serious complication. Radiographs revealed that bony healing was achieved from 3 to 6 months after operation. At the latest follow up, the clinical consequences were graded as excellent in 24 patients, good in 9 and fair in 6, with excellent and good rate of 84.60%. The range of motion of the affected knee got satisfactory recovery in all the patients. [Conclusion] Arthroscopy-assisted reduction and internal fixation take advantages of minimizing trauma, accelerating recovery and reducing complication for Schatzker type Ⅰ-Ⅳ tibial plateau fractures.
作者
方永刚
邱小魁
张鹏
FANG Yong-gang;QIU Xiao-kui;ZHANG Peng(The 91^st Central Hospital of PLA,Jiaozuo 454150,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第22期2103-2106,共4页
Orthopedic Journal of China
关键词
关节镜辅助
微创复位内固定
胫骨平台骨折
arthroscopy
minimally invasive reduction and internal fuxation
tibial plateau fracture
