关节镜下经皮锁定钢板内固定术与开放性锁定钢板内固定术治疗胫骨平台骨折疗效比较

目的比较关节镜下经皮锁定钢板内固定术与开放性锁定钢板内固定术治疗胫骨平台骨折的疗效。方法选取需要手术治疗的胫骨平台骨折（SchatzkerⅠ～Ⅳ型）患者72例，按照数字表法随机分为两组：微创组（37例）采用关节镜下经皮微创锁定钢板内固定；对照组（35例）采用开放性切开复位锁定钢板内固定术。比较两组患者切口长度、术中出血量、手术时间、骨折愈合时间、美国特种外科医院（HSS）评分、并发症及膝关节功能优良率。结果微创组的切口长度、骨折愈合时间明显短于对照组（P均〈0．01），术中出血量明显少于对照组（P〈0．01），HSS评分明显高于对照组（P〈0．05），并发症发生率明显低于对照组（X2=4．8572，P〈0．05），膝关节功能优良率明显高于对照组（X2=5．7312，P〈0．05），差异均有统计学意义。结论关节镜下经皮微创锁定钢板内固定术治疗SchatzkerⅠ～Ⅳ型胫骨平台骨折具有创伤小、操作简单、固定可靠、骨折愈合时间短、膝关节功能恢复快、并发症少、能同时发现和处理关节内并发症等优点，效果较切开复位更有优势。

Efficacy comparison of arthroscopic percutaneous locking plate fixation and open locking plate fix-ation for treatment of tibial plateau fractures

Objective To compare the effect of arthroscopic percutaneous locking plate fixation and open locking plate fixation on therapy of tibial plateau fractures. Methods Seventy-two cases of tib- ial plateau fractures（ type Schatzker I - IV） required surgical treatment were randomly divided into two groups in accordance with the number table： patients in minimally invasive group （37 cases） were trea- ted by arthroscopic percutaneous locking plate fixation; patients in control group （35 cases） were treated by open locking plate fixation. The incision length, surgical blood loss, operative time, fracture healing time, hospital for special surgery （HSS） score, complications and excellent rate of knee function between the two groups were compared. Results The incision length, fracture healing time of the minimally in-vasive group were significantly shorter than those in the control group（all P 〈0. O1 ）; Thesurgical blood loss of the minimally invasive group was significantly less than that in the control group （P 〈 0. 01 ） ; The HSS score of the minimally invasive group was significantly higher than that in the con, trol group （ P 〈 0.05 ） ; The complication rate of the minimally invasive group was significantly lower than that in the control group（ X2 = 4. 8572, P 〈 0.05 ） ; The excellent rate of knee function of the minimally invasive group was significantly higher than that in the control group（ X2 =5. 7312 ,P 〈 0.05 ）. Conclu- sions It has less trauma, simple operation, reliable fixation, short fracture healing time, faster recovery of knee function, fewer complications that arthroscopic percutaneous locking plate fixation for therapy of tibial plateau fractures （type Schatzker I - 1V ）, simultaneous detection and treatment of intra-articular complications, and it has advantage in effect than open reduction.