本文關鍵詞： 關節(jié)鏡 導向器 脛骨平臺骨折 切開復位　出處：《安徽醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的:通過關節(jié)鏡下導向器輔助內固定及傳統(tǒng)切開復位內固定兩種手術方式治療脛骨平臺Schatzker III型骨折,并比較兩種術式的平均手術時間、住院時間、切口大小、術后膝關節(jié)屈曲范圍、膝關節(jié)HSS功能評分及術后并發(fā)癥情況,分析臨床療效差異,以指導手術方法選擇。方法:自2007年9月至2013年9月選取我院脛骨平臺Schatzker III型骨折41例,按照入院先后順序隨機分成A、B兩組,A組20例,B組21例,A組通過關節(jié)鏡下導向器輔助內固定手術治療,B組通過傳統(tǒng)的切開復位內固定手術治療。評估比較兩組病例的臨床資料及術后恢復情況。結果:所有手術均由同一組醫(yī)師完成。A組平均手術時間為94.05±14.43min,B組為112.09±17.12min;A組平均住院時間為7.12±1.05d,B組為14.05±1.19d;A組平均手術切口大小為6.53±1.12cm,B組為13.89±1.05cm,兩組病例平均手術時間、平均住院時間及手術切口大小比較具有統(tǒng)計學差異(p0.05);所有病例均獲得隨訪,術后24個月隨訪時膝關節(jié)屈曲范圍A組平均為125.13±15.41度,B組為108.43±12.65度,兩組數(shù)據(jù)有統(tǒng)計學差異(p0.05);術后24個月膝關節(jié)HSS功能評分A組平均為85.83±8.91分,B組為76.47±8,01分,兩組數(shù)據(jù)有統(tǒng)計學差異(p0.05)。術后并發(fā)癥方面:A組有1例術后小腿腫脹,經治療后好轉,未出現(xiàn)術后感染、膝關節(jié)僵硬、術后關節(jié)疼痛等并發(fā)癥,B組出現(xiàn)術后感染1例,膝關節(jié)僵硬3例,術后關節(jié)疼痛5例,兩組并發(fā)癥例數(shù)比較存在顯著差異(p0.05)。結論:關節(jié)鏡下導向器輔助治療脛骨平臺Schatzker III型骨折具有手術時間及住院時間短、手術切口小等優(yōu)勢,且術后并發(fā)癥少,能獲得良好的膝關節(jié)功能,臨床上應值得推廣應用。
[Abstract]:Objective: to treat Schatzker III fracture of tibial plateau by arthroscopic guidance assisted internal fixation and traditional open reduction internal fixation, and to compare the average operation time, hospital stay and incision size between the two operations. The range of knee flexion, the HSS score of knee joint and the postoperative complications were analyzed to guide the choice of operative methods. Methods: from September 2007 to September 2013, 41 cases of Schatzker III fracture of tibial plateau were selected in our hospital. According to the order of admission, the patients in group A were randomly divided into two groups: group A (n = 20) and group B (n = 21) treated by arthroscopic guidance assisted internal fixation. The patients in group B were treated with traditional open reduction and internal fixation. Results: the average operation time of group A was 94.05 鹵14.43 min and the average hospitalization time of group A was 7.12 鹵1.05 鹵1.05 鹵1.19 days after operation. Results: the mean incision size of group A was 6.53 鹵1.12 cm and that of group B was 13.89 鹵1.05cm. Average operation time, The mean length of hospitalization and the size of surgical incision were significantly different in all cases, and the average flexion range of knee joint was 125.13 鹵15.41 degrees in group A and 108.43 鹵12.65 degrees in group B at 24 months after operation, and the mean length of knee flexion was 125.13 鹵15.41 degrees in group B and 108.43 鹵12.65 degrees in group B after 24 months follow-up. The average score of knee joint HSS function in group A was 85.83 鹵8.91 and that in group B was 76.47 鹵8,01.There was a significant difference between the two groups (p 0.05). There was no postoperative infection, knee joint stiffness, postoperative joint pain and other complications. In group B, postoperative infection occurred in 1 case, knee joint stiffness in 3 cases, and postoperative joint pain in 5 cases. There was a significant difference in the number of complications between the two groups (p 0.05). Conclusion: arthroscopic guidance for the treatment of tibial plateau Schatzker III fracture has the advantages of short operation time, short hospital stay, small incision, and less postoperative complications. Can obtain the good knee joint function, the clinical should be worth popularizing application.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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相關期刊論文 前1條

1 嚴俊;黃彰;謝杰;李峰;;關節(jié)鏡下導向器輔助治療脛骨平臺Schatzker Ⅲ型骨折療效分析[J];中華實用診斷與治療雜志;2015年02期

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本文編號：1536055