Asik Mehmet, Cetik Ozgur, Talu Ufuk, Sozen Yunus V
Department of Orthopedics and Traumatology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2002 Nov;10(6):364-70. doi: 10.1007/s00167-002-0310-2. Epub 2002 Sep 18.
This retrospective review evaluated the results of arthroscopy-assisted surgery for tibial plateau fractures in 45 patients with closed tibial plateau fractures. The fracture involved articular depression in 27 patients in whom lifting and bone grafting with autogenous corticocancellous iliac bone graft was required. In 23 patients there were also meniscal lesions, which were treated by partial resection in 16 and repaired in 7. Internal fixation was performed using screws in 36 knees and plate in 10 knees. Radiological results were evaluated according to the Resnic-Niwoyama criteria; mean follow-up was 36 months (range 14-72). There was no intraoperative complication in the series, but postoperatively there were one infection and one loss of correction. Results were satisfactory in 89% of cases, according the Rasmussen criteria. Arthroscopy is thus an excellent and minimally invasive method for assessment and treatment of tibial plateau fractures. The advantages are complete and anatomical reduction in the fractured articular surface and evaluation of other concomitant intra-articular pathology and entails only little additional morbidity, especially compared to arthrotomy.
这项回顾性研究评估了45例闭合性胫骨平台骨折患者接受关节镜辅助手术的结果。27例骨折累及关节面凹陷，需要采用自体髂骨皮质松质骨进行抬高和植骨。23例患者还伴有半月板损伤，其中16例行部分切除术，7例行修复术。36例膝关节采用螺钉内固定，10例膝关节采用钢板内固定。根据雷斯尼克-新山标准评估影像学结果；平均随访36个月（范围14 - 72个月）。该系列中无术中并发症，但术后有1例感染和1例矫正丢失。根据拉斯穆森标准，89%的病例结果满意。因此，关节镜是评估和治疗胫骨平台骨折的一种优秀的微创方法。其优点是骨折关节面能实现完全解剖复位，可评估其他合并的关节内病变，且仅增加很少的额外发病率，尤其是与切开手术相比。
