关节镜联合经皮内固定技术治疗低能量胫骨平台骨折伴韧带损伤的临床研究
摘要点击次数: 25   全文下载次数: 0   投稿时间:2019-04-10  修订日期:2019-07-03  
作者Author单位AddressE-Mail
曹建国* Cao Jianguo 浙江省玉环市人民医院骨科,317600 Department of Orthopedic,People'
'
s Hospital of Yuhuan City,Zhejiang,325802
523599496@qq.com 
陈宇 Chen Yu 浙江省玉环市人民医院骨科,317600  
陈文辉 Chen Wenhui 浙江省玉环市人民医院骨科,317600  
龙治强 Long Zhiqiang 浙江省玉环市人民医院骨科,317600  
金文锦 Jin wenjing 浙江省玉环市人民医院骨科,317600  
期刊信息:《中国骨伤》年,第卷,第期,第-页
DOI:
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中文摘要:摘要:目的 探讨关节镜辅助下应用经皮内固定(minimally invasive percutaneous plate osteosynthesis,MIPPO)技术治疗低能量胫骨平台骨折(fracture of tibial plateau,FTP)伴韧带损伤患者的影像学指标、膝关节功能等临床疗效。方法 选取自2016年3月至2017年3月收治60例FTP伴韧带损伤患者术前均有膝关节疼痛、肿胀、屈伸活动受限等症状,影像学检查确定骨折类型和韧带损伤。按照随机数字表均分为2组,研究组男14例,女16例;年龄30~63岁,平均年龄47.25士5.36岁,Schatzker分型:I型8例、Ⅱ型12例、Ⅲ型10例,应用关节镜下MIPPO技术。对照组男16例,女14例;年龄32~60岁,平均年龄43.39士4.62岁,Schatzker分型:I型10例、Ⅱ型11例、Ⅲ型9例,应用切开复位内固定术。采用HSS评分评价膝关节功能。 观察比较2组患者影像学指标、膝关节功能、手术指标(切口长度、术后引流量、术中出血量、并发症等)、住院指标(术后下床时间、住院时间)等。结果 60例患者均获随访,时间12-24个月,平均随访时间18个月。两组胫骨平台内翻角(5.16±1.23°vs5.17±1.31°)、后倾角(9.51±1.57°vs9.52±1.33°)、股胫角(178.39±3.01°vs177.57±2.93°)比较差异无统计学意义(P>0.05),研究组伤口感染2例,对照组骨折延迟愈合、伤口感染各3例,经处理愈合。研究组并发症(x2=3.216)、手术和住院指标(切口长度、住院时间、术后引流量、术中出血量)低于对照组,HSS评分(87.68±7.39vs69.42±5.13)高于对照组,差异有统计学意义(P<0.05)。结论 关节镜辅助下应用MIPPO技术治疗低能量FTP伴韧带损伤患者具有创伤小并早期处理韧带半月板损伤,关节功能较好、并发症少等优点,值得推广。
【关键词】胫骨平台骨折  关节镜  经皮内固定  韧带损伤  微创治疗
 
The clinical research of Combing Arthroscopy with MIPPO techniques for low energy tibial plateau fracture with ligament injury
ABSTRACT  Abstract:Objective To evaluate the clinical effect such as imaging index,knee joint function of combing arthroscopy with MIPPO techniques in the FTP patients with ligament injury.Methods From March 2016 to March 2017,60 FTP patients with ligament injury who were suffering knee pain,swelling,flexion and extension limited and other symptoms,imaging examination to determine fracture type and ligament injury.Patients were randomly divided into two groups according to the random number table.The research group including 14 males and 16 females with an average age of 47.25士5.36 years old ranging from 30 to 63 years old,according to Schatzker typing:typeI8 case、typeⅡ12case、typeⅢ10 case were used by arthroscopy with MIPPO techniques.The control group including 16 males and 14 females with an average age of 43.39士4.62 years old ranging from 32 to 60 years old,according to Schatzker typing:typeI10 case、typeⅡ11 case、typeⅢ 9 case were treated by open reduction and internal fixation.The HSS score was used to evaluate knee function.The imaging index,knee joint function,surgical parameters(incision length,bleeding volume,postoperative drainage,complication),hospitalization index(hospital stay,post-operative time)were compared between the two groups.Results 60 patients were followed up for an average of 18 months.The imaging index such as TPA(5.16±1.23°vs5.17±1.31°)、PA(9.51±1.57°vs9.52±1.33°)、FTA(178.39±3.01°vs177.57±2.93°)in the two group were no statistically significant(p>0.05).There were 2 cases of wound infection in the research group,while 3 cases of fracture nonunion and wound infection in the control group,which were healed by treatment.The surgical and hospitalization indexs(hospital stay、postoperative drainage、incision length、bleeding volume、post-operative time、complication)in the research group were lower than the control group,HSS score(87.68±7.39vs69.42±5.13)in the research group were higher than the control group.The differences were statistically significant(p<0.05).Conclusion Arthroscopy assisted MIPPO techniques treating low energy FTP patients with ligament injury has advantages of minimal invasion, management of deal with intra-joint articular injuries,good functional of the knee joint,less complications.It was worth of further clinical application.
KEY WORDS  Tibial Plateau Fractures  Arthroscopy  Minimally Invasive Percutaneous Plate Osteosynthesis  Ligament Injury  Micro- Invasive Treatment
 
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