外侧胫骨平台骨折合并软组织伤的关节镜诊治

目的探讨膝关节镜在外侧胫骨平台骨折伴随软组织损伤中的诊治作用，统计各种软组织损伤的发生率。方法自2007年3月至2012年4月采用关节镜辅助内固定术治疗外侧胫骨平台骨折38例。使用膝关节镜仔细探查合并的软组织损伤，根据不同损伤类型做出相应处理，并统计各类软组织损伤的发生率。结果在本组38例患者中，合并软组织损伤24例（63．2％），其中复合软组织损伤7例（18．4％）。半月板损伤为最常见的软组织损伤，共18例（47．4％）．前交叉韧带损伤7例16例（18．4％），后交叉韧带损伤1例（2．6％），外侧副韧带2例（5．3％），内侧副韧带损伤3例（7．9％），腓总神经损伤2例（5．3％）。结论外侧胫骨平台骨折常伴随不同类型的软组织损伤，使用膝关节镜检查可以对各类伴随的软组织损伤作出正确诊断，并及时采取针对性的治疗。

Arthroscopic Evaluation and Treatment of Soft Tissue Injuries in Tibial Plateau Fractures

Objective To discuss the role of arthroscope in the evaluation and treatment of soft tissue injuries in lateral tibial plateau fractures and assess the frequency of the associated soft tissue injuries. Methods Thirty eight lateral tibial plateau fracture patients were treated by arthroscopic assisted internal fixation between March 2007 and April 2012. The associated injuries were evaluated and treated by arthroscope and then the arthroscopie findings asso- ciated with soft tissue injuries were recorded. Results The frequency of associated soft tissue injury in this series was 63.2%（24/38） and the multiple soft tissue injury 18.4%（7/38）. The menisci were injured in 47.4%of subjects（18/ 38 ）,the anterior eruciate ligament （ACL）in 18.4%//00 （7/38）,the posterior erueiate ligament （PCL）in 2.6% （1/38）,the lateral collateral ligament （I.CL）in 5. 3%（2/38）,the medial collateral ligament （MCL）in 7. 9% （3/38）,the peroneal nerve in 5.3% （2/38）. Conclusion A variety of soft tissue injuries are common in tibial plateau fractures ;and can be accurately diagnosed and accordingly treated with the use of arthroseope. Key words ：arthroscope ;soft tissue injury ;tibial plateau ;fracture