【摘要】 目的 对比分析3D建模联合关节镜辅助与传统切开复位内固定治疗SchatzkerⅡ～Ⅲ型胫骨平台骨折的临床疗效。方法 回顾性分析2018年1月至2021年12月青岛市城阳区人民医院收治的60例SchatzkerⅡ～Ⅲ型胫骨平台骨折患者资料，采用计算机3D建模模拟术前规划联合关节镜辅助治疗的30例患者纳入观察组，采用传统切开复位内固定的30例患者纳入对照组。观察组中男17例，女13例；年龄20～65岁，平均(47.30±11.70)岁。对照组中男16例，女14例；年龄22～65岁，平均(46.37±11.80)岁。比较两组术中相关指标和并发症情况，采用疼痛视觉模拟评分(visual analogue scale, VAS)、美国特种外科医院(hospital for special surgery, HSS)膝关节评分、Rasmussen功能评分和Rasmussen骨折复位评分评估手术疗效。结果 两组手术时间比较差异无统计学意义(P>0.05);观察组术中透视次数、手术切口长度、术后引流量、关节复位时间均明显少于对照组(P<0.05)。患者术后随访均≥12个月，术后3～6个月均达到骨性愈合。术后3 d,观察组VAS低于对照组(P<0.05);术后1个月两组比较差异无统计学意义(P>0.05)。术后1个月，观察组HSS评分、Rasmussen评分明显高于对照组(P<0.05);术后12个月两组比较差异无统计学意义(P>0.05)。术后1个月，观察组HSS优良率为100%,对照组为66.70%;术后12个月，对照组的HSS优良率也达到100%。术后即刻、12个月，观察组Rasmussen骨折复位评分均高于对照组(P<0.05)。结论 相较传统切开复位内固定，3D建模联合关节镜辅助治疗SchatzkerⅡ～Ⅲ型胫骨平台骨折，术中透视次数更少，手术创伤更小，骨折复位精准高效，术后功能康复满意。更多还原

【Abstract】 Objective To compare the clinical efficacy of 3D modeling simulation combined with arthroscopicassisted treatment and traditional open reduction and internal fixation(ORIF)for Schatzker typeⅡtoⅢtibial plateau fractures.Methods A retrospective analysis was conducted on 60patients with Schatzker typeⅡtoⅢtibial plateau fractures treated at The People’s Hospital of Chengyang District from January 2018to December 2021.Thirty patients treated with 3Dmodeling simulation combined with arthroscopic assistance were assigned to the observation group,and30patients treated with traditional ORIF were assigned to the control group.The observation group included 17males and 13females,with a mean age of(47.30±11.70)years(range,20to 65years).The control group included 16males and 14females,with a mean age of (46.37±11.80)years (range,22to 65years).Intraoperative indicators and complications were compared between the two groups.Surgical outcomes were evaluated using the visual analogue scale(VAS)for pain,the hospital for special surgery(HSS)knee score,the Rasmussen functional score,and the Rasmussen fracture reduction score.Results There was no significant difference in operative time between the two groups(P>0.05).The observation group had significantly fewer intraoperative fluoroscopy times,shorter surgical incision length,less postoperative drainage volume,and shorter joint reduction time compared with the control group (P<0.05).All patients were followed up for at least 12months,with bony union achieved at 3to 6months postoperatively.At 3days postoperatively,the VAS score in the observation group was lower than that in the control group (P<0.05).At 1month postoperatively,the HSS and Rasmussen scores in the observation group were significantly higher than those in the control group(P<0.05).The excellent and good rate of the HSS score was 100%in the observation group and 66.70%in the control group at 1month postoperatively;the control group also achieved a 100%excellent and good rate at12months postoperatively.The Rasmussen fracture reduction score in the observation group was higher than that in the control group immediately after surgery and at 12 months postoperatively (P<0.05).Conclusion Compared with traditional ORIF,3Dcombined with arthroscopic-assisted treatment for Schatzker typeⅡtoⅢtibial plateau fractures results in fewer intraoperative fluoroscopy times,less surgical trauma,more precise and efficient fracture reduction,and better functional recovery postoperatively.更多还原