关节镜下导向器辅助内固定与切开复位内固定治疗胫骨平台Schatzker Ⅲ型骨折的疗效对比研究

发布时间：2018-02-26 02:04

本文关键词： 关节镜导向器胫骨平台骨折切开复位　出处：《安徽医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:通过关节镜下导向器辅助内固定及传统切开复位内固定两种手术方式治疗胫骨平台Schatzker III型骨折,并比较两种术式的平均手术时间、住院时间、切口大小、术后膝关节屈曲范围、膝关节HSS功能评分及术后并发症情况,分析临床疗效差异,以指导手术方法选择。方法:自2007年9月至2013年9月选取我院胫骨平台Schatzker III型骨折41例,按照入院先后顺序随机分成A、B两组,A组20例,B组21例,A组通过关节镜下导向器辅助内固定手术治疗,B组通过传统的切开复位内固定手术治疗。评估比较两组病例的临床资料及术后恢复情况。结果:所有手术均由同一组医师完成。A组平均手术时间为94.05±14.43min,B组为112.09±17.12min;A组平均住院时间为7.12±1.05d,B组为14.05±1.19d;A组平均手术切口大小为6.53±1.12cm,B组为13.89±1.05cm,两组病例平均手术时间、平均住院时间及手术切口大小比较具有统计学差异(p0.05);所有病例均获得随访,术后24个月随访时膝关节屈曲范围A组平均为125.13±15.41度,B组为108.43±12.65度,两组数据有统计学差异(p0.05);术后24个月膝关节HSS功能评分A组平均为85.83±8.91分,B组为76.47±8,01分,两组数据有统计学差异(p0.05)。术后并发症方面:A组有1例术后小腿肿胀,经治疗后好转,未出现术后感染、膝关节僵硬、术后关节疼痛等并发症,B组出现术后感染1例,膝关节僵硬3例,术后关节疼痛5例,两组并发症例数比较存在显著差异(p0.05)。结论:关节镜下导向器辅助治疗胫骨平台Schatzker III型骨折具有手术时间及住院时间短、手术切口小等优势,且术后并发症少,能获得良好的膝关节功能,临床上应值得推广应用。
[Abstract]:Objective: to treat Schatzker III fracture of tibial plateau by arthroscopic guidance assisted internal fixation and traditional open reduction internal fixation, and to compare the average operation time, hospital stay and incision size between the two operations. The range of knee flexion, the HSS score of knee joint and the postoperative complications were analyzed to guide the choice of operative methods. Methods: from September 2007 to September 2013, 41 cases of Schatzker III fracture of tibial plateau were selected in our hospital. According to the order of admission, the patients in group A were randomly divided into two groups: group A (n = 20) and group B (n = 21) treated by arthroscopic guidance assisted internal fixation. The patients in group B were treated with traditional open reduction and internal fixation. Results: the average operation time of group A was 94.05 卤14.43 min and the average hospitalization time of group A was 7.12 卤1.05 卤1.05 卤1.19 days after operation. Results: the mean incision size of group A was 6.53 卤1.12 cm and that of group B was 13.89 卤1.05cm. Average operation time, The mean length of hospitalization and the size of surgical incision were significantly different in all cases, and the average flexion range of knee joint was 125.13 卤15.41 degrees in group A and 108.43 卤12.65 degrees in group B at 24 months after operation, and the mean length of knee flexion was 125.13 卤15.41 degrees in group B and 108.43 卤12.65 degrees in group B after 24 months follow-up. The average score of knee joint HSS function in group A was 85.83 卤8.91 and that in group B was 76.47 卤8,01.There was a significant difference between the two groups (p 0.05). There was no postoperative infection, knee joint stiffness, postoperative joint pain and other complications. In group B, postoperative infection occurred in 1 case, knee joint stiffness in 3 cases, and postoperative joint pain in 5 cases. There was a significant difference in the number of complications between the two groups (p 0.05). Conclusion: arthroscopic guidance for the treatment of tibial plateau Schatzker III fracture has the advantages of short operation time, short hospital stay, small incision, and less postoperative complications. Can obtain the good knee joint function, the clinical should be worth popularizing application.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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