微创治疗Schatzker Ⅰ～Ⅲ型胫骨 平台骨折的疗效观察

Minimally invasive treatment of Schatzker type Ⅰ ～ Ⅲ tibial plateau fracture

摘要:

目的 分析微创治疗Schatzker Ⅰ～Ⅲ型胫骨平台骨折的疗效。方法 选取2014 年1 月—2018 年 8 月海警总队医院收治的胫骨平台骨折患者84 例（Schatzker Ⅰ～Ⅲ型），按随机数字表法分为观察组和对照 组，每组42 例。对照组采用手术切开复位钢板内固定；观察组采用微创经皮钢板固定。比较两组手术相关指 标、关节功能恢复及并发症发生情况等。结果 观察组手术时间、手术切口长度、住院时间、术后开始负重 时间及骨折愈合时间短于对照组（P <0.05）。观察组手术前后膝关节活动度、美国膝关节协会评分及骨折复 位评分的差值高于对照组（P <0.05）。观察组术后并发症发生率低于对照组（P <0.05）。结论 采用微创经 皮钢板固定术治疗Schatzker Ⅰ～Ⅲ型胫骨平台骨折的患者，临床效果较好，创伤小、并发症少，术后恢复较快， 具有良好的临床应用价值。

Abstract:

Objective To investigate the efficacy of minimally invasive treatment of Schatzker type Ⅰ ～ Ⅲ tibial plateau fracture. Methods A total of 84 patients with tibial plateau fracture (Schatzker type Ⅰ ～ Ⅲ) admitted to our hospital from January 2014 to August 2018 were selected and divided into observation group (42 cases) and control group (42 cases). The control group was treated with open reduction and plate internal fixation, and the observation group was treated with minimally invasive percutaneous plate fixation. The operation, joint function recovery and complications of the two groups were compared. Results The incision length of the observation group was (10.73 ± 1.12) cm, which was significantly shorter than that of the control group (P < 0.05). The length of operation and hospital stay was shorter in the observation group than that in the control group (P < 0.05). The healing time of fracture and the time to weight bearing were earlier in the observation group than those in the control group (P < 0.05). The differences in the range of motion of knee joint, American knee society knee score, and fracture reduction score before and after the surgery of the observation group were better than those in the control group (P < 0.05). The incidence of postoperative complications in the observation group was lower than that in the control group (P < 0.05). Conclusions Minimally invasive percutaneous plate fixation is of clinical value in the treatment of Schatzker type Ⅰ ～ Ⅲ tibial plateau fractures with better clinical efficacy and less surgery trauma and complications.