关节镜辅助下内固定治疗外侧胫骨平台骨折

目的探讨关节镜辅助下内固定治疗外侧胫骨平台骨折的临床疗效及手术方法。方法自2007年3月至2009年4月对19例外侧胫骨平台骨折患者行关节镜辅助下内固定手术治疗,按Schatzker分型Ⅰ型9例,Ⅱ型4例,Ⅲ型6例。所有患者均应用关节镜探查处理半月板及韧带等合并损伤,并在关节镜监视下行骨折复位、支撑钢板或拉力螺钉内固定术。结果 19例患者均在术后3~4个月获得骨性愈合,无局部感染、骨筋膜室综合征、深静脉血栓等并发症发生。最后一次随访HSS评分平均87.9分（67分~98分）,优良率94.7%。结论关节镜辅助内固定术治疗外侧胫骨平台骨折临床效果良好,可同时处理关节腔内合并组织损伤,具有较高的临床应用价值。

Treatment of Lateral Plateau Tibial Fractures with Arthroscopic Reduction and Internal Fixation

Objective To discuss the clinical results and operative technique of arthroscopic reduction and internal fixation（ARIF） in the treatment of lateral tibial plateau fractures.Methods Nineteen lateral tibial plateau fracture patients were treated by ARIF between March 2007 and April 2009.There were 9 type Ⅰ,4 type Ⅱ,6 type Ⅲ fractures according to Schatzker criteria.The combined injuries were examined and treated by arthroscope and then the fracture reduction and internal fixation were also finished under arthroscope.Results All the fractures unioned within 3-4 months after the operation with no complications like local infection,osteofascial compartment syndrome and deep vein thrombosis found.The mean HSS score at the last follow up was 87.9（67~98）.The rate of excellent and good was 94.7%.Conclusion ARIF is a good choice in the treatment of lateral tibial plateau fractures for it has a good clinical result and the combined injuries can also be treated at the same time.