摘要
目的探讨关节镜下微创经皮钢板内固定技术(MIPPO)治疗SchatzkerⅡ~Ⅴ型胫骨平台骨折的效果。方法将33例胫骨平台骨折患者按Schatzker分型在关节镜下结合MIPPO技术对累及关节面骨块进行复位和钢板螺钉内固定。对半月板损伤予以成形或修补处理,对前交叉韧带止点撕脱骨折行一期修复,前后交叉韧带断裂待骨愈合后二期行韧带重建。结果患者均获得随访,时间18~32个月。骨折均达到骨性愈合,时间3~5个月。末次随访膝关节主动活动度为伸膝0°,屈膝100°~130°。末次随访Rasmussen评分为23~28(25.7±1.5)分,其中优25例,良8例,无可、差病例。结论关节镜下MIPPO技术治疗SchatzkerⅡ~Ⅴ型胫骨平台骨折具有诊断明确、关节面复位好、创伤小、术后功能恢复快等优点。
Objective To explore the therapeutic effect of arthroscopic-assisted reduction and minimally invasive percutaneous plate osteosynthesis（ MIPPO） on the treatment of Schatzker type Ⅱ - Ⅴ tibial plateau fractures. Methods Thirty-three cases of tibial plateau fractures were classified by Schatzker classification. All patients received articular surface reduction with arthroscopic-assisted reduction and MIPPO technique. The meniscus injury were reshaped or repaired,the anterior cruciate ligament insertion fractures were fixed at one-stage operation,while the anterior and posterior cruciate ligament rupture was reconstructed after the bone union. Results The patients were all followed up for 18 - 32 months. All the fractures reached bone healing after 3 - 5 months. At the final follow-up,the active range of the knee was extention 0° and flexion 100° - 130°. The final follow-up Rasmussen score was 23 - 28（ 25. 7 ± 1. 5）points. The function of the joint was excellent in 25 cases,good in 8 cases. Conclusions The arthroscopic-assisted reduction and MIPPO technique has advantages in the diagnosis of intra-articular fracture,reduction of the articular surface,minimal invasive aspect and quick functional recovery for the treatment of Schatzker type Ⅱ - Ⅴ tibial plateau fractures.
出处
《临床骨科杂志》
2017年第2期202-205,共4页
Journal of Clinical Orthopaedics
基金
广东省卫计委医学科研基金(编号:A2016066)
关键词
胫骨平台骨折
关节镜检查
微创经皮钢板内固定
tibial plateau fracture
arthroscopy
minimally invasive percutaneous plate osteosynthesis
