膝关节镜辅助下微创手术与传统手术治疗胫骨平台骨折的临床疗效比较

发布时间：2019-03-03 18:44

【摘要】：目的分析膝关节镜辅助下手术治疗胫骨平台骨折的临床疗效,并对该治疗方法的特点进行探讨。方法采用前瞻性研究的方法将60例患者随机分为观察组与对照组,每组各30例。观察组采用膝关节镜辅助下有限切开骨折复位内固定的方式进行治疗,对照组采用传统切开复位内固定的方法。其中合并半月板游离缘破裂18例,合并前交叉韧带胫侧止点撕脱骨折11例,合并内侧副韧带断裂9例。在手术结束后,观察两组患者的手术时间、切口长度,并在手术后对两组患者随访1年,根据美国特种外科医院评分(HSS)膝关节功能标准对其疗效进行评定。结果两组患者经过治疗后,观察组患者的手术时间为(81.6±21.7)min,明显低于对照组患者的(109.7±31.6)min;观察组患者的切口长度明显短于对照组患者的切口长度,两组比较差异有统计学意义(P0.05)。观察组手术后并发症发生率为3.3%,对照组手术后并发症发生率为20.0%,两组比较差异有统计学意义(P0.05)。在临床疗效上,观察组患者的优良率为96.7%,明显优于对照组患者的60.0%,两组比较差异有统计学意义(P0.05)。结论采用膝关节镜辅助下手术治疗胫骨平台骨折,能够在最大程度上提高患者的治愈率,降低并发症的概率,并且具有创伤小、复位直观和固定可靠等特点,值得临床上进行推广。
[Abstract]:Objective to analyze the clinical effect of arthroscopic surgery on tibial plateau fracture and to discuss the characteristics of the treatment. Methods 60 patients were randomly divided into observation group and control group with 30 cases in each group. The observation group was treated with limited open reduction and internal fixation assisted by arthroscopy, while the control group was treated with traditional open reduction and internal fixation. Among them, there were 18 cases with meniscus dissociative rupture, 11 cases with tibial avulsion fracture of anterior cruciate ligament and 9 cases with medial collateral ligament rupture. At the end of the operation, the operation time and incision length of the two groups were observed, and the two groups were followed up for 1 year. The curative effect was evaluated according to the (HSS) knee joint function standard of the United States Special Surgical Hospital. Results after treatment, the operative time in the observation group was (81.6 卤21.7) min, which was significantly lower than that in the control group (109.7 卤31.6) min;. The incision length of the observation group was significantly shorter than that of the control group, the difference between the two groups was statistically significant (P0.05). The incidence of postoperative complications was 3.3% in the observation group and 20.0% in the control group. There was a significant difference between the two groups (P0.05). In the clinical effect, the excellent and good rate of the observation group was 96.7%, which was significantly higher than that of the control group (60.0%). The difference between the two groups was statistically significant (P0.05). Conclusion the surgical treatment of tibial plateau fracture with arthroscopy can improve the cure rate and reduce the probability of complications to the maximum extent, and has the characteristics of less trauma, visual reduction and reliable fixation. It is worth popularizing clinically.
【作者单位】：新疆石河子大学医学院第一附属医院骨三科;新疆石河子大学医学院第一附属医院骨一科;新疆石河子大学医学院第一附属医院骨二科;
【分类号】：R687.3

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