Buchko G M, Johnson D H
Mineral Springs Hospital, Banff, Alberta, Canada.
Clin Orthop Relat Res. 1996 Nov(332):29-36. doi: 10.1097/00003086-199611000-00006.
In recent years the treatment of fractures has evolved from extensive open reduction and internal fixation to minimally invasive surgery and biologically benign internal fixation. The ultimate goal of treatment for tibial plateau fractures is to prevent the late development of degenerative osteoarthritis. Surgery is often required to restore joint congruity and alignment, to stabilize the knee, and to allow early joint motion. In most cases, these goals can be achieved through arthroscopic reduction and internal fixation. Arthroscopic reduction and internal fixation offers the advantage of direct visualization of the fracture and its subsequent reduction without a formal arthrotomy or detachment of the anterior horn of the lateral meniscus. Not all types of fractures are amenable to arthroscopic reduction and internal fixation, such as severe bicondylar fractures. This technique is now evolving and some Schatzker Type 6 fractures have been treated with traction on the fracture table, arthroscopy assisted reduction, limited internal fixation of the articular surface, followed by rigid external fixation.
近年来，骨折治疗已从广泛的切开复位内固定发展为微创手术和生物相容性良好的内固定。胫骨平台骨折治疗的最终目标是预防退行性骨关节炎的晚期发展。通常需要手术来恢复关节的一致性和对线，稳定膝关节，并允许早期关节活动。在大多数情况下，这些目标可以通过关节镜下复位和内固定来实现。关节镜下复位和内固定的优点是可以直接观察骨折及其随后的复位情况，而无需进行正式的关节切开术或外侧半月板前角的分离。并非所有类型的骨折都适合关节镜下复位和内固定，例如严重的双髁骨折。这项技术目前正在不断发展，一些Schatzker 6型骨折已通过在骨折台上牵引、关节镜辅助复位、关节面有限内固定，然后进行坚强外固定来治疗。
