关节镜监视下手术治疗胫骨平台塌陷骨折22例临床分析

目的：对胫骨平台塌陷骨折关节镜辅助诊断和治疗方法进行初步探讨。方法：2006年5月～2010年7月对22例胫骨平台塌陷骨折病人关节镜辅助下手术治疗。即常规关节镜检查，根据关节镜检查所见，对软骨损伤、半月板损伤、滑膜炎、韧带撕裂进行关节镜下修复、清理，且关节镜监视下进行骨折复位和固定。其中男18例，女4例，年龄22～55岁；车祸伤16例，跌伤4例，坠落伤2例。外侧髁塌陷骨折18例，内侧髁塌陷骨折4例，以外翻性损伤多见。所有病例均为单髁、闭合性损伤，于2～6天内手术治疗。结果：本组22例，所有病人骨折均解剖复位，经随访5～18个月骨折均愈合，骨块未出现移位、塌陷，未见创伤性关节炎发生。疗效：优16例，良3例，中3例；优良率86．3％。结论：关节镜辅助下手术治疗胫骨平台塌陷骨折，重视关节软骨损伤和半月板损伤的治疗，具有手术损伤小、平台塌陷骨折对位确切、术后恢复快等优点，提高了诊疗效果。

Arthroscopic treatment of tibial plateau fracture of 22 cases

objective：Discussed the methods of diagnosis and treatment tibial plateau fracture by Arthroscopic .Methods：2006 .5-2010 .7 , 22 cases of tibial plateau fracture patients collapse assisted arthroscopic surgery .The conventional arthroscopy , seen under arthroscopy , cartilage injury , meniscus injury ,synovitis , arthroscopic ligament tear for repair , cleaning , and fracture under arthroscopic reduction and fixation.Including 18 males and 4 females, aged 22 to 55 years;traffic accident in 16 cases, 4 cases of falls, fall injuries in 2 cases.Collapse of the lateral condyle fracture in 18 cases,4 cases of fracture of the medial condyle of collapse , Valgus injurys were more common.All cases were single condyle , blunt trauma, all in treatment at 2 to 6 days.Results：22 cases, fractures are anatomic reduction of all patients , after 5 to 18months of follow -up , fracture healing , bone does not appear displacement , collapse , and no traumatic arthritis.Efficacy：excellent in 16 cases, good in 3 cases, 3 medium;good rate of 86.3%.Concluis on：Arthroscopic-assisted surgical treatment of tibial plateau fracture collapse , attention to articular cartilage and meniscus treatment , with less surgical damage , platform collapse fracture on the exact position , the advantages of rapid recovery , improved clinical results .