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关节镜辅助骨折固定术。

Arthroscopy-assisted fracture fixation.

机构信息

Musculoskeletal Research Lab, Division of Orthopaedics, St. Michael's Hospital, 30 Bond Street, Shuter Wing 5-076, Toronto, ON, M5B 1W8, Canada.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2011 Feb;19(2):320-9. doi: 10.1007/s00167-010-1298-7. Epub 2010 Nov 17.

Abstract

PURPOSE

the purpose of this article was to systematically analyze the results of published studies in the literature which evaluated the use of arthroscopically assisted techniques in intra-articular fracture fixation.

METHODS

published investigations to date were analyzed by classifying them according to joints that were involved with intra-articular fractures including: knee, ankle, hip, shoulder, elbow, and wrist joints. The results were studied to assess the feasibility, efficiency, and outcomes of arthroscopy-assisted fracture fixation.

RESULTS

arthroscopy-assisted techniques have been used successfully for the treatment of fractures of the tibial plateau, tibial eminence, malleoli, pilon, calcaneus, femoral head, glenoid, greater tuberosity, distal clavicle, radial head, coronoid, distal radius, and scaphoid. The major advantages of arthroscopic fracture fixation over open methods are direct visualization of the intra-articular space, decreased invasiveness, and the possibility for multitask interventions through which fixation of the fracture, and repair of the soft tissues and the cartilage can be performed simultaneously. The time-consuming and technically demanding nature of the procedures with a prolonged learning curve and limited fixation alternatives are the main disadvantages of this technique.

CONCLUSION

arthroscopic fixation is increasingly utilized for certain intra-articular fracture types due to the minimally invasive nature of the procedures and high accuracy. Randomized controlled trials are needed to justify wider use of arthroscopy-assisted techniques for treatment of intra-articular fractures.

摘要

目的

本文旨在系统分析评估关节镜辅助技术在关节内骨折固定中应用的文献研究结果。

方法

通过将涉及关节内骨折的关节进行分类,包括膝关节、踝关节、髋关节、肩关节、肘关节和腕关节,对迄今为止已发表的调查进行分析。研究结果评估了关节镜辅助骨折固定的可行性、效率和结果。

结果

关节镜辅助技术已成功应用于治疗胫骨平台、胫骨嵴、内外踝、PILON 骨折、跟骨、股骨头、肩盂、大结节、锁骨远端、桡骨小头、喙突、桡骨远端和舟骨骨折。与开放式方法相比,关节镜骨折固定的主要优点是可以直接观察关节内空间、减少侵袭性,并且可以同时进行多项任务干预,从而实现骨折固定、软组织和软骨修复。该技术的主要缺点是手术耗时且技术要求高,学习曲线长,固定选择有限。

结论

由于手术的微创性和高精度,关节镜固定越来越多地用于某些关节内骨折类型。需要进行随机对照试验来证明关节镜辅助技术更广泛地用于治疗关节内骨折的合理性。

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