吴冰 杨溯 李园

【摘要】 胫骨平台骨折属于关节内骨折，常伴半月板、韧带等结构损伤。外科治疗遵循全修复的理念，在恢复下肢力线的同时修复关节内损伤结构，恢复关节稳定性并降低术后感染、创伤性骨关节炎等并发症发生率。传统开放手术创伤大且术后并发症多。关节镜辅助技术因其创伤小、解剖复位好、对关节腔内合并损伤的处理及术后恢复快等优点逐渐成为胫骨平台骨折的首选治疗方式。故本文对关节镜下辅助复位内固定治疗胫骨平台骨折的手术适应证及预后，微创优势和新技术创新做一综述。

【关键词】 胫骨平台骨折 关节镜辅助 微创

Research Progress of Arthroscopic-assisted Treatment for Tibial Plateau Fractures/WU Bing， YANG Su， LI Yuan. //Medical Innovation of China， 2021， 18（12）： -188

[Abstract] Tibial plateau fractures are intra-articular fracture patterns associated with meniscus tears， ligament and other structural injuries. Base on the overall repair concept of surgery， which should restore the line of gravity of lower limb and timely repair of injured structural in order to resume the joint stability and reduce the incidence of postoperative infection or posttraumatic osteoarthritis. Traditional open surgery is traumatic and has many postoperative complications. Arthroscopic-assisted technique has gradually become the first choice for the treatment of tibial plateau fracture due to its advantages such as less trauma， better anatomical reduction， quick treatment of joint lumen combined injury and quick postoperative recovery. Therefore， this paper reviewed the surgical indications and prognosis， minimally invasive advantages and new technical innovations of arthroscopy assisted reduction and internal fixation for tibial plateau fractures.

[Key words] Tibial plateau fractures Arthroscopic-assisted Minimally invasive

First-authors address： Changzhi Medical College， Changzhi 046000， China

doi：10.3969/j.issn.1674-4985.2021.12.045

脛骨平台骨折占所有成人骨折的1%～2%[1]，是由创伤所致的关节内骨折，骨折机制复杂且常常伴有半月板、附属韧带、关节囊等结构的损伤。最新一项基于人群的流行病学研究显示大约1/3的胫骨平台骨折为双髁粉碎性骨折，这种复杂骨折手术的显露及复位对外科医生极具挑战性[2]。手术的主要目的是骨折解剖复位和坚强固定，恢复膝关节功能和降低创伤性骨关节炎等并发症的发生率。但有证据表明恢复下肢力线和膝关节稳定性对保证膝关节功能更加重要[3]，因此胫骨平台骨折的治疗应在解剖复位和重建关节稳定性的基础上，遵循骨折与关节周围软组织全修复的理念，即全面评估韧带、半月板等结构损伤并及时修复，避免术后膝关节失稳及创伤性骨关节炎的加速进展[4-5]。……