【摘要】 [目的]探讨关节镜引导下复位联合锁定加压钢板内固定微创治疗胫骨平台骨折SchatzkerⅠ、Ⅱ、Ⅲ型的临床疗效。[方法]2006年1月~2008年12月,对22例胫骨平台骨折(Ⅰ~Ⅲ型)患者,采用关节镜辅助下进行复位,骨缺损处予以植骨,并以锁定加压钢板固定。其中男性14例,女性8例。年龄22~65岁,平均38.7岁。Ⅰ型3例,Ⅱ型8例,Ⅲ型11例。合并半月板游离缘破裂6例,前交叉韧带损伤3例,内侧副韧带损伤1例。[结果]本组骨折均愈合,所有患者均获得随访。随访时间12~30个月,平均20个月。骨折愈合时间3~4.2个月,平均3.3个月。随访期内无术后复位丢失,无创伤性骨关节炎。采用Rasmussen评分标准,优15例,良5例,可2例,优良率90.9。[结论]对于低能量型膝关节损伤患者的治疗,关节镜监视下复位联合锁定加压钢板固定具有复位精确,手术创伤小,术后并发症少,能有效减少畸形愈合,为Ⅰ~Ⅲ型胫骨平台骨折较理想的手术方法。更多还原

【Abstract】 [Objective]To discuss the clinical effect of minimally invasive treatment on Schatzker typeⅠ-Ⅲ tibial plateau fractures with the technique of reduced by arthroscopy assisted and fixed by locking compression plate.[Methods]From January 2006 to December 2008,22 patients with tibial plateau fractures(SchatzkerⅠ-Ⅲ)were reduced with arthroscopy assisted,and bone defects were filled with homogeneous allograft bone,and fixed by LCP,including 14 males and 8 females.Their age are from 22 to 65 years old(average 38.7 years old).There were 3 cases of typeⅠ,8 cases of typeⅡ,and 11 cases of type Ⅲ.The fractures combined with meniscus rupture in 6 cases,with ACL(anterior cruciate ligament)injury in 3 cases,and with medial collateral ligament injury in 1 cases.[Results]All of the fractures in 22 cases were union within 3-4.2 months(average 3.3 months).After following up period of 12-30 months(average 20 months),there were no reduction loss and traumatic knee osteoarthritis.According to criteria of Rasmussen,excellent were in 15 cases,good in 5 cases,and fair in 2 case,with the rate of being excellent and good was added up to 90.9%.[Conclusion]Arthroscopy assisted operative management with locking compression plate fixation can help reduction more precisely for the low energy tibial plateau fractures with the advantage of less invasion,lower complication rate and reduce malunion.It is a preferable method for Schatzker typeⅠ-Ⅲ tibial plateau fracutures treatment.更多还原