复杂胫骨平台骨折关节镜辅助下微创手术治疗(1)
[摘要] 目的 研究关节镜辅助下微创手术治疗复杂胫骨平台骨折的临床疗效。 方法 将2015年6月～2016年6月在我院接受治疗的60例复杂胫骨平台骨折患者随机分为两组，对照组30位患者采用传统的切开复位内固定治疗，观察组30位患者实施关节镜辅助下微创手术治疗。 结果 观察组患者治疗优良率(93.33%)显著优于对照组(66.67%)。观察组患者术中出血量、手术时间、住院时间及骨折愈合时间显著短于对照组，观察组患者VAS评分显著低于对照组，HSS评分及屈伸活动度显著高于对照组。 结论 关节镜辅助下微创手术治疗可显著提高患者临床治疗优良率，缩短患者手术时间、住院时间及骨折愈合时间，降低术中出血量及疼痛感，术后关节功能恢复与活动度恢复情况理想。
[摘要] 复杂胫骨平台骨折；关节镜；微创手术；切开复位内固定
[中图分类号] R683.4 [文献标识码] A [文章编号] 2095-0616(2017)06-162-03
[Abstract] Objective To study the clinical curative effect of minimally invasive surgical treatment of complex tibial plateau fractures under arthroscope. Methods 60 cases of complex tibial plateau fractures cured in our hospital from June 2015 to June 2016 were selected and randomly divided into two groups.30 cases in control group were treated with traditional open reduction and internal fixation，and 30 cases in observation group were treated with arthroscopic assisted minimally invasive surgery. Results The excellent and good rate of the observation group (93.33%) was significantly better than that of the control group (66.67%).The amount of bleeding，operation time，hospitalization time and fracture healing time in observation group were significantly shorter than those in the control group.The VAS score of the observation group was significantly lower than that of the control group，the HSS score and the flexion and extension activity of the observation group were significantly higher than those of the control group. Conclusion Arthroscopic assisted minimally invasive surgery can significantly improve the clinical treatment of patients with excellent rate，shorten the operation time， hospitalization time and fracture healing time，and reduce intraoperative blood loss and pain.The recovery of joint function and the recovery of activity are satisfactory.
[Key words] Complex tibial plateau fractures；Arthroscope；Minimally invasive surgery；Open reduction and internal fixation
复杂胫骨平台骨折多存在關节面破坏，治疗不当易导致创伤性关节炎、关节不稳等后遗症[1]。传统手术需切开关节、剥离软组织，复位评估不直观，且手术并发症发生率高[2]，随着骨折治疗理念更新，微创治疗成为医患共同的追求。关节镜能提供良好关节内视野，直接观察关节面复位、确保螺钉不进入关节腔，有利于下肢力线及关节间隙恢复，保证骨折良好复位；关节镜下冲洗可较彻底清除骨碎片，减少感染及骨关节炎发生，有效提高复杂平台骨折疗效[3]。本研究对复杂胫骨平台骨折患者实施关节镜辅助下微创手术治疗的情况进行分析，具体情况报道如下。
1 资料与方法
1.1 一般资料
选择2015年6月～2016年6月在我院接受治疗的60例复杂胫骨平台骨折患者均签署知情同意书。经过伦理委员会批准按照随机数字法平均分为观察组(30例)和对照组(30例)。对照组男15例，女15例；年龄21～72岁，平均(41.4±4.9)岁。按Sehatzker型分型：4例Ⅳ型，12例V型，14例Ⅵ型。观察组男14例，女16例；年龄22～74岁，平均(42.6±5.5)岁。按Sehatzker型分型：5例Ⅳ型，11例V型，14例Ⅵ型。两组间一般资料比较差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(郭仰丹 林涌生 郑宁)
[摘要] 复杂胫骨平台骨折；关节镜；微创手术；切开复位内固定
[中图分类号] R683.4 [文献标识码] A [文章编号] 2095-0616(2017)06-162-03
[Abstract] Objective To study the clinical curative effect of minimally invasive surgical treatment of complex tibial plateau fractures under arthroscope. Methods 60 cases of complex tibial plateau fractures cured in our hospital from June 2015 to June 2016 were selected and randomly divided into two groups.30 cases in control group were treated with traditional open reduction and internal fixation，and 30 cases in observation group were treated with arthroscopic assisted minimally invasive surgery. Results The excellent and good rate of the observation group (93.33%) was significantly better than that of the control group (66.67%).The amount of bleeding，operation time，hospitalization time and fracture healing time in observation group were significantly shorter than those in the control group.The VAS score of the observation group was significantly lower than that of the control group，the HSS score and the flexion and extension activity of the observation group were significantly higher than those of the control group. Conclusion Arthroscopic assisted minimally invasive surgery can significantly improve the clinical treatment of patients with excellent rate，shorten the operation time， hospitalization time and fracture healing time，and reduce intraoperative blood loss and pain.The recovery of joint function and the recovery of activity are satisfactory.
[Key words] Complex tibial plateau fractures；Arthroscope；Minimally invasive surgery；Open reduction and internal fixation
复杂胫骨平台骨折多存在關节面破坏，治疗不当易导致创伤性关节炎、关节不稳等后遗症[1]。传统手术需切开关节、剥离软组织，复位评估不直观，且手术并发症发生率高[2]，随着骨折治疗理念更新，微创治疗成为医患共同的追求。关节镜能提供良好关节内视野，直接观察关节面复位、确保螺钉不进入关节腔，有利于下肢力线及关节间隙恢复，保证骨折良好复位；关节镜下冲洗可较彻底清除骨碎片，减少感染及骨关节炎发生，有效提高复杂平台骨折疗效[3]。本研究对复杂胫骨平台骨折患者实施关节镜辅助下微创手术治疗的情况进行分析，具体情况报道如下。
1 资料与方法
1.1 一般资料
选择2015年6月～2016年6月在我院接受治疗的60例复杂胫骨平台骨折患者均签署知情同意书。经过伦理委员会批准按照随机数字法平均分为观察组(30例)和对照组(30例)。对照组男15例，女15例；年龄21～72岁，平均(41.4±4.9)岁。按Sehatzker型分型：4例Ⅳ型，12例V型，14例Ⅵ型。观察组男14例，女16例；年龄22～74岁，平均(42.6±5.5)岁。按Sehatzker型分型：5例Ⅳ型，11例V型，14例Ⅵ型。两组间一般资料比较差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(郭仰丹 林涌生 郑宁)