楊曉光

[摘要] 目的 探討膝關(guān)節(jié)鏡輔助復(fù)位鎖定鋼板內(nèi)固定術(shù)治療脛骨平臺(tái)骨折的臨床價(jià)值。 方法 回顧性選取克孜勒蘇柯爾克孜自治州人民醫(yī)院骨科2018年12月至2020年6月收治的92例脛骨平臺(tái)骨折患者，根據(jù)治療方式分為常規(guī)組與微創(chuàng)組，每組各46例，常規(guī)組采用切開復(fù)位鎖定金屬接骨鋼板內(nèi)固定術(shù)治療，微創(chuàng)組則采用膝關(guān)節(jié)鏡輔助復(fù)位鎖定金屬接骨鋼板內(nèi)固定術(shù)治療，比較兩組手術(shù)用時(shí)、術(shù)中失血量、術(shù)后引流量、術(shù)前與術(shù)后2周膝關(guān)節(jié)功能（HSS）評分，并評價(jià)兩組治療后臨床療效;術(shù)后隨訪6個(gè)月，比較兩組并發(fā)癥發(fā)生情況。 結(jié)果 微創(chuàng)組手術(shù)用時(shí)、術(shù)中出血量及術(shù)后引流量均少于常規(guī)組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;治療前兩組HSS評分比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），治療后2周微創(chuàng)組HSS評分為（90.69±2.15）分，高于常規(guī)組的（78.53±3.82）分，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;微創(chuàng)組臨床優(yōu)良率（93.48%）高于常規(guī)組（73.91%）;術(shù)后隨訪6個(gè)月，微創(chuàng)組并發(fā)生發(fā)生率（2.17%）低于常規(guī)組（13.04%）。 結(jié)論 膝關(guān)節(jié)鏡輔助復(fù)位鎖定金屬接骨鋼板內(nèi)固定術(shù)治療脛骨平臺(tái)骨折臨床療效顯著，可有效縮短手術(shù)用時(shí)、減少失血量，有利于膝關(guān)節(jié)功能的恢復(fù)，具有較高的臨床應(yīng)用價(jià)值。

[關(guān)鍵詞] 膝關(guān)節(jié)鏡;脛骨平臺(tái)骨折;鎖定鋼板內(nèi)固定術(shù);臨床療效

[中圖分類號] R683.4? ? ? ? ? [文獻(xiàn)標(biāo)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.