谢文生　林影　陈荣汉

[摘要] 目的 探讨关节镜下经皮与开放性锁定钢板内固定术治疗胫骨平台骨折的临床效果。 方法 选取本院2011年10月～2014年12月诊治的胫骨平台骨折患者112例，采用随机数字表法分为两组，56例患者采用开放性锁定钢板内固定术治疗为对照组，56例患者采用关节镜下经皮锁定钢板内固定术治疗为观察组，比较两组的治疗效果。 结果 观察组患者的手术时间、术后住院时间、下地负重时间、骨折愈合时间均明显短于对照组，术中出血量明显少于对照组，切口长度明显小于对照组，优良率、Rusmussen评分均明显高于对照组，并发症发生率明显低于对照组（P<0.05）。 结论 关节镜下经皮与开放性锁定钢板内固定术均是治疗胫骨平台骨折的有效方法，其中关节镜下经皮锁定钢板内固定术的创伤小，效果显著，安全性高。

[关键词] 关节镜；经皮锁定钢板内固定术；开放性锁定钢板内固定术；胫骨平台骨折

[中图分类号] R683.42 [文献标识码] A [文章编号] 1674-4721（2015）09（a）-0067-04

[Abstract] Objective To investigate clinical effect of arthroscopic percutaneous and open locking plate internal fixation in treatment of tibial plateau fracture. Methods 112 patients with tibial plateau fracture diagnosed and treated in our hospital were selected from October 2011 to December 2014 and they were randomly divided into two groups according to the random number table method.56 patients treated open locking plate internal fixation were selected as control group，while 56 patients treated arthroscopic percutaneous locking plate internal fixation were selected as observation group.Treatment effect was compared between two groups. Results Operation time，postoperative hospitalization time，load time，fracture healing time in patients of observation group was significantly shorter than that of control group respectively，intraoperative bleeding volume was significantly less than that of control group，cut length was significantly smaller than that of control group and excellent and good rate and Rusmussen score was significantly higher than that of control group，and the incidence rate of complication was significantly lower than that of control group （P<0.05）. Conclusion Arthroscopic percutaneous and open locking plate internal fixation are effective methods in treatment of tibial plateau fracture. Arthroscopic percutaneous locking plate internal fixation has less trauma，which has notable efficacy and high safety.

[Key words] Arthroscopy；Percutaneous locking plate internal fixation；Open locking plate internal fixation；Tibial plateau fracture

胫骨平台骨折是临床常见病症，属于膝关节创伤性骨折，多为高能量暴力或轴向压力所致，可造成粉碎性骨折和关节面塌陷，患者多伴有不同程度的韧带、半月板、血管损伤，给患者带来明显疼痛的同时，也降低了机体的生理功能和生活质量[1-2]。如果不能给予患者及时有效的治疗和处理，可造成畸形愈合和残疾。目前，临床治疗胫骨平台骨折的方案有多种，手术治疗更为常用[3-4]，随着微创技术的不断应用和发展，关节镜逐渐用于胫骨平台骨折的治疗。本研究选取胫骨平台骨折患者112例进行研究，以探讨关节镜下经皮锁定钢板内固定术与开放性锁定钢板内固定术治疗胫骨平台骨折的临床效果。……