两种手术方式治疗胫骨平台骨折效果比较
Comparison of the clinical efficacy of two surgical methods for tibial plateau fractures
摘要目的:比较关节镜辅助复位与传统手术方式治疗胫骨平台骨折的临床效果。方法选取胫骨平台骨折(SchatzkerⅠ~Ⅳ型)患者75例,按数字表法随机分为关节镜组和传统手术组,比较两组术后并发症发生率、手术时间、切口长度、术中及术后出血量、住院时间以及临床功能优良率,观察两种手术方式的临床疗效和应用价值。结果关节镜组并发症发生率(2.70%)较传统手术组(21.3%)显著降低(χ2=5.980,P =0.014);关节镜组手术时间[(88.1±15.2)min]较传统手术组[(103.8±22.1)min]显著缩短(t =3.575,P =0.001);关节镜组切口长度[(6.7±2.3)cm]较传统手术组[(10.8±2.7)cm]显著缩短(t =5.745,P =0.000);关节镜组住院时间[(4.5±2.3)d]较传统手术组[(6.5±3.1)d]显著缩短(t =3.166,P =0.003);关节镜组患者术中+术后出血量[(145.2±43.0)mL]亦较传统手术组[(294.4±90.2)mL]显著减少(t =7.829,P =0.000);关节镜组术后临床功能优良率(86.49%)较传统手术组(71.05%)显著提高(χ2=3.723, P =0.039)。结论应用关节镜辅助下骨折复位内固定治疗胫骨平台骨折(SchatzkerⅠ~Ⅳ型),具有并发症发生率低、创伤小、手术时间短以及术后膝关节功能优良率高等优点,值得广泛推广。
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abstractsObjective To compare the efficacy between arthroscopic assisted reduction and traditional opera-tion approach for the treatment of tibial plateau fractures.Methods 75 patients with tibial plateau fracture(SchatzkerⅠ -Ⅳ type)were recruited,which were randomly divided into the arthroscopic and traditional operation group according to different treatment methods.The clinical efficacy and value of arthroscopically assisted reduction was ana-lyzed and compared according to the incidence of postoperative complications,the operative time,incision length,blood loss,hospital stay,and clinical efficacy between the two groups.Results Compared with the data in the traditional operation group,the incidence of postoperative complications (2.70% vs.21.3%)was significantly lower(χ2 =5.980,P =0.014).The operative time[(88.1 ±15.2)min vs.(103.8 ±22.1)min]was significantly shorter(t =3.575,P =0.001).And the incision length[(6.7 ±2.3)cm vs.(10.8 ±2.7)cm)]declined greatly(t =5.745,P =0.000).The hospital stay time and blood loss were significantly lower than that of the traditional operation group[(4.5 ± 2.3)d vs.(6.5 ±3.1)d;(145.2 ±43.0)mL vs.(294.4 ±90.2)mL,respectively],and the differences were statisti-cally significant(t =3.166,P =0.003;t =7.829,P =0.000,respectively).The excellent rate of clinical features in arthroscopic group(86.49%)was higher than that of traditional operation group(71.05%),and the difference was statistically significant(χ2 =3.723,P =0.039).Conclusion Arthroscopic -assisted reduction has many features for the tibial plateau fractures (SchatzkerⅠ -Ⅳ type),such as lower incidence of postoperative complications,less trau-ma,shorter operative time,and better postoperative knee function and so on,so it is worthy of clinical application.
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