关节镜辅助内固定治疗胫骨上端骨折中远期疗效评价

目的观察关节镜辅助内固定治疗胫骨上端骨折的中远期疗效。方法选取应用关节镜辅助内固定技术进行胫骨上端骨折治疗并完成随访研究的患者100例,通过电话回访、门诊复查或调查问卷的形式,辅助以X线检查进行随访,根据检查结果进行Lysholm功能评分、Irrgang评分以及Rasmussen功能评分、Rasmussen放射性评分,评估关节镜辅助内固定治疗方法的中远期治疗效果。结果随访结果显示,患者术后Irrgang及Lysholm评分状况良好,对Ⅱ、Ⅲ、Ⅳ型骨折患者两种评分的分值分别进行比较,差异无统计学意义（P〉0.05）;年龄大于60岁、术中发现伴有胫骨/股骨侧软骨损伤、关节内软组织损伤等因素,对胫骨的恢复和影像学结果具有消极影响。结论关节镜辅助内固定手术治疗胫骨上端骨折具有良好的中远期疗效,但对于年龄较大、伴有胫骨/股骨侧软骨损伤等并发症的患者,在治疗中应格外注意,以期获得良好的预后。

Intermediate and long term curative effects of arthroscopy-assisted internal fixation in treatment of tibial fracture

Objective To observe the intermediate and long term curative effects of arthroscopy-assisted internal fixation in treatment of tibial fracture. Methods Total 100 patients were selected to receive arthroscopy-assisted internal fixation in treatment of tibial fracture in order to make a follow-up research. Follow-up visits were carried out by means of telephone, reexamination, or questionnaire, assisted by X-ray examination, and then, Lysholm function scores, Irrgang scores, Rasmussen function scores, Rasmussen radiation scores were marked according to the examination results, and finally the intermediate and long term curative effects of arthroscopy-assisted internal fixation in treatment of tibial fracture were evaluated. Results The follow-up results showed that the postoperative Irrgang and Lysholm scores of the patients were good, and there were no significant difference between the two kinds of scores of the patients with type Ⅱ, Ⅲ and IV fractures （ P 〉 0.05 ） ; the ages older than 60 years and other factors, e. g. , intraoperative findings associated with tibial and femoral lateral cartilage injury as well as intra-articular soft tissue injury, had negative effects on tibial recovery and imaging results. Conclusion Arthroscopy-assisted internal fixation in the treatment of tibial fracture has intermediate and long term curative effect;however, for senile patients associated with tibial and femoral lateral cartilage injury and other complications, more attention should be paid in order to obtain good prognosis.