摘要
目的：研究关节镜下治疗膝关节内骨折的手术方法和最佳功能恢复途径.方法：关节镜监视下治疗膝关节内骨折157例,其中胫骨平台骨折78例,男41例,女37例,年龄18～75岁,平均47岁;按Schatzker分类：Ⅰ型23例,Ⅱ型18例,Ⅲ型20例,Ⅳ型9例,V型5例,Ⅵ型3例.髌骨骨折24例,男15例,女9例,年龄19～72岁,平均47岁;横行骨折12例,纵行骨折3例.下级骨折6例,粉碎性骨折3例;胫骨髁间棘骨折36例,男25例,女11例,年龄25～65岁,平均43岁;按Meyors和Mckeeverj分类：Ⅱ型25例,Ⅲ型11例.股骨髁骨折19例,男12例,女7例,年龄22～71岁,平均45岁;单髁骨折14例,髁间骨折5例（“Y”形2例,“T”形3例）.术中通过皮肤微小切口植入松质骨螺钉或螺栓、松质骨拉力螺钉、支撑钢板内固定,骨缺损处用自体髂骨或同种异体骨植骨,术后配合早期的功能训练辅以多种康复干预措施.结果：所有患者均得到随访（13～50个月）,采用ROM和Lysholm评分标准评价临床疗效,其优良率分别是87.9%（138/157）和90.4%（142/157）.结论：关节镜下微创手术为治疗膝关节内骨折提供了一种新方法,具有创伤小、并发症少、早期功能锻炼、术后功能恢复好等优点,多种康复干预措施有利于膝关节功能的全面恢复。
Objective：To explore operative method of ＂Minimally invasive surgery＂ for the treatment of intra-articular fractures of knee joint under arthroseope and its best functional rehabilitation pathway. Methods：157 patients with intra-articular fractures of knee joint were treated under arthroscope. 78 cases were tibial plateau fracture. Male to female was 41：37 and the mean age was 47（18 -75）years old. Type I - Ⅳ was 23, 18,20,9,5,3 ,respectively, according to Sehatzker classification. 24 eases were patellar fracture elassifed into transverse fracture （ 12 ）, longitudinal fracture （ 3 ）, distal fracture （ 6 ） and comminuted fracture （ 3 ）. 36 cases were the intercondylar spine of tibia,and the mean age was 43（25 -65）years old. Type Ⅱ was 25 and typeⅢ was 11 according to Meyors and Mckeeverj classification. 19 cases were femoral condyle fracture which 14 cases were hemicondylar fracture,2 intereondylar Y fracture and 3 intereondylar T fracture. We inserted in screws or plate through minimally invasive incision. The autografts of ilium or bone allografts were applied where the bone was defected. Moreover, the early rehabilitation training assisted many interference measures were carried out on patients after operation. Results：All the patients were followed up from 13 to 50 months. According to standard of ROM and Lysholm knee rating system：the rate of excellent and good was 87. 9% （138/157） and 90. 4%, （142/157） respectively. Conclusion：＂ Minimally invasive surgery＂ for the treatment of intra-artieular fractures of knee joint under arthroseope has the advantages of minimal trauma, less complication, early rehabilitation training and well funictional recovery. So it offers a new method for the treatment of intra-articular fractures of knee joint. Many interference measures avail the comprehensive recovery of knee joint function.
出处
《中国骨伤》
CAS
2006年第4期203-206,共4页
China Journal of Orthopaedics and Traumatology
关键词
关节镜检查
膝关节
关节内骨折
Arhroscopy
Knee joint
Intra-articular fractures
