膝关节镜辅助复位锁定钢板内固定术治疗胫骨平台骨折的临床价值

杨晓光

[摘要] 目的 探討膝关节镜辅助复位锁定钢板内固定术治疗胫骨平台骨折的临床价值。 方法 回顾性选取克孜勒苏柯尔克孜自治州人民医院骨科2018年12月至2020年6月收治的92例胫骨平台骨折患者，根据治疗方式分为常规组与微创组，每组各46例，常规组采用切开复位锁定金属接骨钢板内固定术治疗，微创组则采用膝关节镜辅助复位锁定金属接骨钢板内固定术治疗，比较两组手术用时、术中失血量、术后引流量、术前与术后2周膝关节功能（HSS）评分，并评价两组治疗后临床疗效;术后随访6个月，比较两组并发症发生情况。 结果 微创组手术用时、术中出血量及术后引流量均少于常规组，差异有统计学意义（P<0.05）;治疗前两组HSS评分比较，差异无统计学意义（P>0.05），治疗后2周微创组HSS评分为（90.69±2.15）分，高于常规组的（78.53±3.82）分，差异有统计学意义（P<0.05）;微创组临床优良率（93.48%）高于常规组（73.91%）;术后随访6个月，微创组并发生发生率（2.17%）低于常规组（13.04%）。 结论 膝关节镜辅助复位锁定金属接骨钢板内固定术治疗胫骨平台骨折临床疗效显著，可有效缩短手术用时、减少失血量，有利于膝关节功能的恢复，具有较高的临床应用价值。

[关键词] 膝关节镜;胫骨平台骨折;锁定钢板内固定术;临床疗效

[中图分类号] R683.4          [文献标识码] B          [文章编号] 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.