关节镜下治疗胫骨平台塌陷骨折的疗效分析

目的总结和探讨膝关节镜治疗胫骨平台塌陷骨折28例。方法本组28例,男18例,女10例;年龄22～58岁。均为胫骨平台塌陷骨折,手术时间为伤后2 h～10 d。SchaterzkerⅡ型骨折20例,Ⅲ型骨折8例。根据HSS评分系统分析骨折愈合情况、功能恢复情况判断效果。结果术后随访6～12个月,除1例Ⅲ型骨折高度再次丢失外,其余27例均达到骨性愈合,未发生明显关节面下沉的现象,关节功能恢复总优良率82.1%。结论关节镜下采用空心螺钉与锁定钢板联合应用,结合自体骨及纳米人工骨植骨术治疗SchaterzkerⅡ～Ⅲ型胫骨平台骨折,能有效避免复位后的再丢失,纳米人工骨作为骨移植替代材料,具有良好的临床应用前景。

Effect of operation on tibial plateau collapsed fracture under arthroscope

Objective To summarize and discuss the effect of operational treatment of tibial plateau collapsed fracture under arthroscope.Methods 28 cases diagnosed as tibial plateau collapsed fracture were analyzed,including 18 males and 10 females,ranging in age from 22 to 58 years.Operation was conducted 2h to10d after injury.According to Schatzker criteria,20 were type II and another 8 type Ⅲ.HSS standard was adopted to assess fracture healing and function recovery.Judgment was thus made about the effect of the operation.Results All patients were followed up for 6 to 12 months.27 cases were osseously healed.No obvious articular surface collapse occurred.The fine recovery rate was 82.1%.Conclusion Arthroscopically assisted locking plate inner fixation technique in combination with screws and artificial bone plus bone graft to treat Schaterzker ⅡtoⅢ tibial plateau fracture can effectively avoid loss after reposition.It is worth to be clinically applied.