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关节镜监视下辅助治疗胫骨平台骨折的新型复位器的研制和临床应用
Hits: 1198   Download times: 411   Received:June 12, 2022    
作者Author单位UnitE-Mail
黄兴锐 HUANG Xing-rui 苏州市吴江区中医医院骨伤科, 江苏 苏州 215200 Department of Orthopedics, Wujiang District Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China 31554370@qq.com 
蒋元斌 JIANG Yuan-bin 苏州市吴江区中医医院骨伤科, 江苏 苏州 215200 Department of Orthopedics, Wujiang District Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China  
杨崇山 YANG Chong-shan 苏州市吴江区中医医院骨伤科, 江苏 苏州 215200 Department of Orthopedics, Wujiang District Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China  
徐浩 XU Hao 苏州市吴江区中医医院骨伤科, 江苏 苏州 215200 Department of Orthopedics, Wujiang District Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China  
方姝晨 FANG Shu-chen 苏州市吴江区中医医院骨伤科, 江苏 苏州 215200 Department of Orthopedics, Wujiang District Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China  
陈小微 CHEN Xiao-wei 苏州市吴江区中医医院骨伤科, 江苏 苏州 215200 Department of Orthopedics, Wujiang District Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China  
陈程 CHEN Cheng 苏州市吴江区中医医院骨伤科, 江苏 苏州 215200 Department of Orthopedics, Wujiang District Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China  
李豪 LI Hao 苏州市吴江区中医医院骨伤科, 江苏 苏州 215200 Department of Orthopedics, Wujiang District Hospital of Traditional Chinese Medicine, Wujiang 215200, Jiangsu, China  
期刊信息:《中国骨伤》2023年36卷,第6期,第570-573页
DOI:10.12200/j.issn.1003-0034.2023.06.013
基金项目:苏州市科技局资助项目(编号:SYSD2020049)


目的:研制一种关节镜监视下辅助治疗胫骨平台骨折的复位器,并探讨其临床意义。

方法:自2018年5月至2019年9月治疗21例胫骨平台骨折患者,其中男17例,女4例;年龄18~55(38.6±8.7)岁;SchatzkerⅡ型5例,Ⅲ型16例。均采用自行设计的复位器结合关节镜进行辅助复位,微创经皮钢板固定技术治疗(minimally invasive percutaneous plate osteosynthesis,MIPPO)。通过观察手术时间、出血量、骨折愈合时间等情况,以及采用美国特种外科医院(hospital for special knee score,HSS)、国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分标准进行膝关节功能疗效分析。

结果:21例患者均获得随访,时间8~24(14.0±3.1)个月,手术时间、切口长度、术中出血量、术后负重时间、骨折愈合时间及并发症发生例数分别为70~95(81.7±7.6) min、4~7(5.3±0.9) cm、20~50(35.3±5.2) ml、30~50(35.1±9.2) d、65~90(75.0±4.4) d、0例。骨折获得良好愈合,无螺钉钢板断裂。术后18个月HSS、IKDC膝关节功能评分高于术前(P<0.05)。

结论:胫骨平台骨折复位器设计合理、操作简捷,采用自行设计的复位器可在术中有效的复位骨折,具有快速复位和固定、微创的优点。
[关键词]:胫骨平台  骨折闭合复位  MIPPO  复位器
 
Development and clinical application of a new reduction device for the treatment of tibial plateau fracture under arthroscopic monitoring
Abstract:

Objective To develop a reduction device for the arthroscopy-assisted treatment of tibial plateau fracture and explore its clinical efficacy.

Methods From May 2018 to September 2019, 21 patients with tibial plateau fracture were treated, including 17 males and 4 females. Their ages ranged from 18 to 55 years old with an average of (38.6±8.7) years old. There were 5 cases of Schatzker typeⅡand 16 cases of Schatzker type Ⅲ. The self-designed reductor combined with arthroscope was used for auxiliary reduction and fixation(minimally invasive percutaneous plate osteosynthesis). The efficacy was analyzed by observing the operation time, blood loss, fracture healing time and knee function(HSS and IKDC scoring criteria).

Results All the 21 patients were followed up for 8 to 24 with an average of(14.0±3.1) months. The operative time ranged from 70 to 95 min with an average of(81.7±7.6)min, incision length ranged from 4 to 7 cm with an average of(5.3±0.9) cm, intraoperative blood loss ranged from 20 to 50 ml with an average of(35.3±5.2) ml, postoperative weight-bearing time ranged from 30 to 50 d with an average of(35.1±9.2) d, fracture healing time ranged from 65 to 90 d with an average of(75.0±4.4) d, and complications were 0 cases, respectively. The fracture was well healed and no screw plate fracture was observed. The knee function scores of HSS and IKDC 18 months after operation were significantly higher than those before operation(P<0.05).

Conclusion The custom-made reduction tool for the arthroscopic management of tibial plateau fracture is reasonable in design and simple in operation. The specific reduction tool could effectively reduce the fracture, and shorten the fixation time with minimally invasive procedure.
KEYWORDS:Tibial plateau  Closed fracture reduction  MIPPO  Redactor
 
引用本文,请按以下格式著录参考文献:
中文格式:黄兴锐,蒋元斌,杨崇山,徐浩,方姝晨,陈小微,陈程,李豪.关节镜监视下辅助治疗胫骨平台骨折的新型复位器的研制和临床应用[J].中国骨伤,2023,36(6):570~573
英文格式:HUANG Xing-rui,JIANG Yuan-bin,YANG Chong-shan,XU Hao,FANG Shu-chen,CHEN Xiao-wei,CHEN Cheng,LI Hao.Development and clinical application of a new reduction device for the treatment of tibial plateau fracture under arthroscopic monitoring[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(6):570~573
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