本文關(guān)鍵詞： 關(guān)節(jié)鏡 導(dǎo)向器 脛骨平臺(tái)骨折 切開復(fù)位　出處：《安徽醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過關(guān)節(jié)鏡下導(dǎo)向器輔助內(nèi)固定及傳統(tǒng)切開復(fù)位內(nèi)固定兩種手術(shù)方式治療脛骨平臺(tái)Schatzker III型骨折,并比較兩種術(shù)式的平均手術(shù)時(shí)間、住院時(shí)間、切口大小、術(shù)后膝關(guān)節(jié)屈曲范圍、膝關(guān)節(jié)HSS功能評(píng)分及術(shù)后并發(fā)癥情況,分析臨床療效差異,以指導(dǎo)手術(shù)方法選擇。方法:自2007年9月至2013年9月選取我院脛骨平臺(tái)Schatzker III型骨折41例,按照入院先后順序隨機(jī)分成A、B兩組,A組20例,B組21例,A組通過關(guān)節(jié)鏡下導(dǎo)向器輔助內(nèi)固定手術(shù)治療,B組通過傳統(tǒng)的切開復(fù)位內(nèi)固定手術(shù)治療。評(píng)估比較兩組病例的臨床資料及術(shù)后恢復(fù)情況。結(jié)果:所有手術(shù)均由同一組醫(yī)師完成。A組平均手術(shù)時(shí)間為94.05±14.43min,B組為112.09±17.12min;A組平均住院時(shí)間為7.12±1.05d,B組為14.05±1.19d;A組平均手術(shù)切口大小為6.53±1.12cm,B組為13.89±1.05cm,兩組病例平均手術(shù)時(shí)間、平均住院時(shí)間及手術(shù)切口大小比較具有統(tǒng)計(jì)學(xué)差異(p0.05);所有病例均獲得隨訪,術(shù)后24個(gè)月隨訪時(shí)膝關(guān)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(jì)學(xué)差異(p0.05);術(shù)后24個(gè)月膝關(guān)節(jié)HSS功能評(píng)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(jì)學(xué)差異(p0.05)。術(shù)后并發(fā)癥方面:A組有1例術(shù)后小腿腫脹,經(jīng)治療后好轉(zhuǎn),未出現(xiàn)術(shù)后感染、膝關(guān)節(jié)僵硬、術(shù)后關(guān)節(jié)疼痛等并發(fā)癥,B組出現(xiàn)術(shù)后感染1例,膝關(guān)節(jié)僵硬3例,術(shù)后關(guān)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(jié)論:關(guān)節(jié)鏡下導(dǎo)向器輔助治療脛骨平臺(tái)Schatzker III型骨折具有手術(shù)時(shí)間及住院時(shí)間短、手術(shù)切口小等優(yōu)勢(shì),且術(shù)后并發(fā)癥少,能獲得良好的膝關(guān)節(jié)功能,臨床上應(yīng)值得推廣應(yīng)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(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 嚴(yán)俊;黃彰;謝杰;李峰;;關(guān)節(jié)鏡下導(dǎo)向器輔助治療脛骨平臺(tái)Schatzker Ⅲ型骨折療效分析[J];中華實(shí)用診斷與治療雜志;2015年02期

，

本文編號(hào)：1536055