胫骨平台骨折的膝关节镜微创治疗

目的 探索膝关节镜下处理胫骨平台骨折的疗效与特点.方法 本组患者33例,合并半月板游离缘破裂10例,前交叉韧带胫侧止点撕脱骨折3例,内侧副韧带完全断裂3例.伤后2-10 d内手术,根据骨与软组织损伤情况,将膝关节镜检查治疗技术与传统手术结合进行处理.结果 术后平均随访2年4个月,根据国际HSS膝功能判定的标准评定疗效,其优良率为93.9%,无明显并发症.结论 关节镜监视与协助下微创治疗平台骨折,手术创伤小,利于早期锻炼;可避免因软骨和滑膜长时间暴露而产生的退行性病变和关节内粘连等;可监视和协助平台关节面的复位,提高复位的准确性;同时可探查并修复半月板、交叉韧带损伤.

Minimally invasive treatment for the fracture of tibial plateau using arthroscopy of knee joint

Objective To investigate the therapeutic effect and feature of arthroscopy of knee joint in the treatment of the fracture of tibial plateau. Methods Of 33 cases involved in the study, there were 10 cases complicating rupture of menisci free margin ,3 cases complicating avulsion fracture of the lateral insertion of anterior cruciate ligament, 3 cases were combined with completely medial collateral ligaments rupture. They were operated in 2-10 days after being hurted, combining the technique of arthroscope of knee joint and tradition operation methods together on the basis of the situation of the injured bone and cartilage. Results The follow-up lasted for average 32 months, which showed that 93.8% of patients achieved good to excellent functional evaluation according to the international HSS knee score. Conclusion Treatment for fracture of tibia] plateau with arthroscopy of knee joint is minimally invasive, and the patients can take functional training at earlier period. It can obviate the degenerative process and adhesions in joints due to cartilage and synovial membrane exposed for a long time. Arthroscopy can monitor and help the reestablishment of the plateau joint surface, improve the accuracy of reestablishment,and explore and repair the trauma of cruciate ligament and menisci as well.