Chan Yi-Sheng
Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chang Gung Med J. 2011 May-Jun;34(3):239-47.
Like other intra-articular fractures, the tibial plateau fracture is challenging for orthopedic surgeons because of its severity of trauma, associated soft tissue injuries. Open reduction incurs serious complications, especially wound healing after traditional dissections. Unsatisfactory results often occur in complex or bicondylar tibial plateau fractures. Traditional surgical methods achieved satisfactory results in 70-80% of cases. However, these methods have a high incidence of complications including loss of reduction, infection, and septic arthritis. The advantages of arthroscopy-assisted reduction and internal fixation include direct visualization of intra-articular fracture, accurate fracture reduction, and reduced morbidity. It is straightforward in the diagnosis and treatment of meniscal and ligamentous injuries, and removal of loose fragments. Good early to medium-term results of arthroscopically assisted osteosynthesis of tibial plateau fractures have been reported. The author reviews the current surgical principles, pitfalls, approaches, clinical results, and complications of arthroscopyassisted surgery for tibial plateau fractures.
与其他关节内骨折一样,胫骨平台骨折因其创伤的严重性及相关软组织损伤,对骨科医生而言具有挑战性。切开复位会引发严重并发症,尤其是传统切开术后的伤口愈合问题。复杂或双髁胫骨平台骨折常常效果不佳。传统手术方法在70%至80%的病例中能取得满意效果。然而,这些方法并发症发生率高,包括复位丢失、感染和化脓性关节炎。关节镜辅助复位及内固定的优点包括可直接观察关节内骨折情况、准确复位骨折以及降低发病率。在半月板和韧带损伤的诊断与治疗以及清除游离碎片方面操作简便。已有报道称关节镜辅助下胫骨平台骨折接骨术取得了良好的早中期效果。作者回顾了关节镜辅助手术治疗胫骨平台骨折的当前手术原则、陷阱、入路、临床结果及并发症。