关节镜下经皮螺钉内固定治疗胫骨平台骨折
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摘要
目的探讨分析为SchatzkerⅠ～Ⅲ型胫骨平台骨折患者实施关节镜辅助经皮螺钉内固定手术治疗的临床效果。方法 2014年2月—2018年4月,将86例SchatzkerⅠ～Ⅲ型胫骨平台骨折患者随机等分为两组,每组各43例。为参照组行传统切开复位内固定手术治疗,针对研究组实施关节镜辅助经皮螺钉内固定手术治疗,观察比较两组的治疗有效率、手术持续时间、手术切口长度、术中累计出血量、骨折愈合时间、Lysholm评分,以及雍氏评分。结果研究组的治疗有效率高于参照组,差异有统计学意义(P <0.05)。研究组的手术持续时间、手术切口长度、术中累计出血量,以及骨折愈合时间均低于参照组,差异有统计学意义(P <0.05)。研究组的Lysholm评分和雍氏评分均高于参照组,差异有统计学意义(P <0.05)。结论为骨科临床中确诊收治的SchatzkerⅠ～Ⅲ型胫骨平台骨折患者实施关节镜辅助经皮螺钉内固定手术治疗,能获取较好结果。
Objective To investigate and analyze the clinical effect of arthroscopic-assisted percutaneous screw fixation for Schatzker type I～III tibial plateau fractures. Methods From February 2014 to April 2018, 86 patients with Schatzker type I～III tibial plateau fractures were randomly divided into two groups, 43 patients in each group. For the reference group, traditional open reduction and internal fixation were performed. arthroscopy-assisted percutaneous screw internal fixation was performed in the study group. The therapeutic efficacy, operative duration, operative incision length, cumulative intraoperative bleeding, fracture healing time and Lysholm score were observed and compared between the two groups. The calculated value and Yong's score index. Results The effective rate of treatment in the study group was higher than that in the control group, the difference between the two groups was statistically significant(P < 0.05). The operation duration, incision length, cumulative blood loss and fracture healing time in the study group were lower than those in the control group, the difference between the two groups was statistically significant(P < 0.05). The Lysholm score index and Yongshi score index in the study group were higher than those in the control group, the difference between the two groups was statistically significant(P < 0.05). Conclusion Arthroscopy-assisted percutaneous screw internal fixation for Schatzker type Ⅰ-Ⅲ tibial plateau fracture can obtain better results.
Objective To investigate and analyze the clinical effect of arthroscopic-assisted percutaneous screw fixation for Schatzker type I～III tibial plateau fractures. Methods From February 2014 to April 2018, 86 patients with Schatzker type I～III tibial plateau fractures were randomly divided into two groups, 43 patients in each group. For the reference group, traditional open reduction and internal fixation were performed. arthroscopy-assisted percutaneous screw internal fixation was performed in the study group. The therapeutic efficacy, operative duration, operative incision length, cumulative intraoperative bleeding, fracture healing time and Lysholm score were observed and compared between the two groups. The calculated value and Yong's score index. Results The effective rate of treatment in the study group was higher than that in the control group, the difference between the two groups was statistically significant(P < 0.05). The operation duration, incision length, cumulative blood loss and fracture healing time in the study group were lower than those in the control group, the difference between the two groups was statistically significant(P < 0.05). The Lysholm score index and Yongshi score index in the study group were higher than those in the control group, the difference between the two groups was statistically significant(P < 0.05). Conclusion Arthroscopy-assisted percutaneous screw internal fixation for Schatzker type Ⅰ-Ⅲ tibial plateau fracture can obtain better results.
引文
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[5]张爱玲,吕辉照,赵枫,等.可注射型人工骨与异体松质骨治疗骨质疏松性胫骨平台SchatzkerⅡ型骨折的植骨效果比较[J].生物骨科材料与临床研究,2018,15(3):23-28.
[6]付彦杰,何俊,张雨.胫骨平台骨折患者钢板内固定治疗后继发膝创伤性关节炎的危险因素Logistic回归分析[J].临床医学研究与实践,2018,3(17):110-111.
[7]王冬燕,雷可殷,顾先君,等.双切口金属植入物内固定联合伤骨再生汤治疗SchatzkerⅤ、Ⅵ型胫骨平台双髁骨折疗效及对骨转换生化标志物、炎症因子的影响[J].现代中西医结合杂志,2018,27(13):1444-1447.
[8]吴晓阳,马冬苗,马虎升.间接复位联合有限切开治疗SchatzkerⅤ、Ⅵ型胫骨平台合并胫骨干骨折的疗效观察[J].微创医学,2018,13(1):84-86.
[9]杨海龙,沈鑫,谢荣辉,等.关节镜辅助复位内固定与传统切开复位内固定治疗胫骨平台骨折患者的疗效比较[J].医疗装备,2017,30(22):4-5.
[10]唐勇,邹宏,王辉,沈建平,等.临时跨关节外固定联合延期接骨板内固定治疗SchatzkerⅤ~Ⅵ型胫骨平台骨折效果分析[J].中华骨与关节外科杂志,2017,10(5):433-437.
[11]吴旋,史法见,赵小龙,等.内侧主切口联合外侧微创切口与双切口治疗SchatzkerⅥ型胫骨平台骨折疗效比较[J].中国临床研究,2016,29(12):1691-1694.
[12]白克文,周雪峰,彭军,等.外固定架与双接骨板分期治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折的临床效果分析[J].中华骨与关节外科杂志,2016,9(6):508-511.
[13]邱卫华,孔祥雪,李鉴轶,等.3D打印技术指导胫骨平台SchatzkerⅡ、Ⅲ型骨折复位的初步应用[J].中国临床解剖学杂志,2016,34(6):697-699.
[14]刘伟,苏伟,程建文,等.三维打印技术在SchatzkerⅤ、Ⅵ型胫骨平台骨折手术治疗中的指导作用[J].实用医学杂志,2016,32(22):3713-3716.
[2]栾彦军,张民泽.关节镜下经皮植骨螺钉内固定治疗胫骨平台SchatzkerⅠ~Ⅲ型型骨折[J].创伤外科杂志,2015,17(4):341-344.
[3]杨光辉,刘锦波.漂浮体位和倒L切口在治疗伴后外侧壁劈裂骨折的SchatzkerⅥ型、Ⅴ型胫骨平台骨折中的应用价值[J].当代医药论丛,2018,16(16):7-9.
[4]姜景尧,陈永田,丘天雄,等.关节镜辅助下复位内固定和传统切开内固定治疗SchatzkerⅢ型胫骨平台骨折的效果比较[J].中外医学研究,2018,16(21):21-22.
[5]张爱玲,吕辉照,赵枫,等.可注射型人工骨与异体松质骨治疗骨质疏松性胫骨平台SchatzkerⅡ型骨折的植骨效果比较[J].生物骨科材料与临床研究,2018,15(3):23-28.
[6]付彦杰,何俊,张雨.胫骨平台骨折患者钢板内固定治疗后继发膝创伤性关节炎的危险因素Logistic回归分析[J].临床医学研究与实践,2018,3(17):110-111.
[7]王冬燕,雷可殷,顾先君,等.双切口金属植入物内固定联合伤骨再生汤治疗SchatzkerⅤ、Ⅵ型胫骨平台双髁骨折疗效及对骨转换生化标志物、炎症因子的影响[J].现代中西医结合杂志,2018,27(13):1444-1447.
[8]吴晓阳,马冬苗,马虎升.间接复位联合有限切开治疗SchatzkerⅤ、Ⅵ型胫骨平台合并胫骨干骨折的疗效观察[J].微创医学,2018,13(1):84-86.
[9]杨海龙,沈鑫,谢荣辉,等.关节镜辅助复位内固定与传统切开复位内固定治疗胫骨平台骨折患者的疗效比较[J].医疗装备,2017,30(22):4-5.
[10]唐勇,邹宏,王辉,沈建平,等.临时跨关节外固定联合延期接骨板内固定治疗SchatzkerⅤ~Ⅵ型胫骨平台骨折效果分析[J].中华骨与关节外科杂志,2017,10(5):433-437.
[11]吴旋,史法见,赵小龙,等.内侧主切口联合外侧微创切口与双切口治疗SchatzkerⅥ型胫骨平台骨折疗效比较[J].中国临床研究,2016,29(12):1691-1694.
[12]白克文,周雪峰,彭军,等.外固定架与双接骨板分期治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折的临床效果分析[J].中华骨与关节外科杂志,2016,9(6):508-511.
[13]邱卫华,孔祥雪,李鉴轶,等.3D打印技术指导胫骨平台SchatzkerⅡ、Ⅲ型骨折复位的初步应用[J].中国临床解剖学杂志,2016,34(6):697-699.
[14]刘伟,苏伟,程建文,等.三维打印技术在SchatzkerⅤ、Ⅵ型胫骨平台骨折手术治疗中的指导作用[J].实用医学杂志,2016,32(22):3713-3716.