关节镜和手术下治疗胫骨平台Schatzker各型骨折的疗效比较分析

Comparison between arthroscopy and open reduction method in the treatment of various types of Schatzker tibial plateau fractures

摘要:

目的：探讨关节镜下和常规手术下治疗胫骨平台Schatzker各型骨折疗效比较。方法：我院从2005年3月至2011年10月，共收集206例胫骨平台骨折患者的临床资料，符合标准共126例，其中在关节镜下治疗有67例（S组），在常规手术下治疗共59例（O组）。除2例外，其余病例均获得11～16个月随访，平均14个月。结果：２种手术方式在手术时间、术中出血、切口长度、术后住院时间、伤口愈合时间、术后并发症以及术后1年美国特种外科医院（hospital for special surgery，HSS）膝关节功能评分等方面比较，差异具有统计学意义。结论：关节镜下治疗胫骨平台骨折Ⅰ～Ⅲ型比常规手术具有诊断准确、创伤小、功能恢复早，并发症少等优点，而在Ⅳ～Ⅵ型骨折中，常规手术比关节镜辅助下治疗功能恢复要更加满意。

Abstract:

Objective：To compare the efficacy between arthroscopy and open reduction method in the treatment of various types of Schatzker tibial plateau fractures. Methods：Clinical data of 206 patients with tibial plateau fractures admitted to our hospital during March 2005 to October 2011 were collected and analyzed retrospectively. Totally 126 patients were included in this comparative study based on fracture patterns and were divided into two groups. Sixty-seven patients were treated by arthroscopically assisted management and the remaining 59 patients underwent conventional open method. All patients excepting two were followed up for 11 to 16 months after the operation，with an average time of 14 months. Results：There were significant differences between both groups in terms of op－eration time，intraoperative blood loss，incision length and postoperative hospitalization duration，postoperative complications and knee functional score at one year postoperatively. Conclusions：With the advantages of accurate diagnosis，minimally invasive，quick recovery and few complications，arthroscopy is more effective in the treatment of typeⅠ-Ⅲ tibial plateau fracture；however，conventional open reduction is more effective in the treatment of type Ⅳ-Ⅵ tibial plateau fractures.