关节镜监控下经皮内固定处理胫骨平台骨折

目的对关节镜监控下经皮内固定和切开复位内固定处理的胫骨平台骨折的结果作评估。方法对随访时间超过1年的53例SchatzkerⅠ、Ⅱ、Ⅲ型胫骨平台骨折进行了回顾性研究。其中,23例接受关节镜手术（S组）,30例接受开放手术内固定术（O组）。结果两组在手术时间、膝关节活动度、Rasmussen功能评分方面差异无统计学意义;但S组膝关节屈曲到120°的平均时间早于O组S组8.3±2.3周;O组（10.9±3.0）周];S组病人的平均住院时间短于O组病人S组（6.1±1.8）d;O组（9.3±1.9）d]。结论关节镜监控下经皮内固定处理SchatzkerⅠ型、Ⅱ型、Ⅲ型胫骨平台骨折可以获得良好的近、中期效果,是值得推荐的一种手术方法。

Arthroscopic reduction and percutaneous internal fixation of tibial plateau fractures

Objective To evaluate arthroscopic reduction and percutaneous internal fixation versus open reduction and internal fixation of tibial plateau fractures of Schatzker＇s typeⅠ,Ⅱ and Ⅲ.Methods Fifty-three patients were included in this comparative study based on fracture patterns and divided into two groups.Using Schatzker＇s classification system,patients with typeⅠ,type Ⅱ and type Ⅲ were included.Twenty-three of these patients were treated by arthroscopically assisted management（group S）,and the remaining 30 underwent the conventional open method（group O）.Results There was no significant difference between two groups in terms of duration of operation,range of motion,and clinical results.In group S,however,the postoperative rehabilitation was easier and faster the time to obtain 120° of flexion was（8.3±2.3）weeks in group S,and（10.9±3.0）weeks in group O].Also,accurate diagnosis and treatment of any associated joint pathology was possible with arthroscopic management.Conclusion The arthroscopic reduction and percutaneous internal fixation is recommended in Schatzker＇s typeⅠ,Ⅱ and Ⅲ tibial plateau fractures.