Lobenhoffer P, Schulze M, Tscherne H
Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
Unfallchirurg. 1996 Aug;99(8):569-75.
The role of closed reduction techniques in tibial plateau fractures was evaluated retrospectively in a group of 33 patients. The patients had mainly B fractures (AO classification) and were treated by the arthroscopic reduction technique (n = 10) or by reduction under fluoroscopic control (n = 23) and transcutaneous screw fixation. The 21 patients with an average follow-up of 34 months (minimum 1 year) were reviewed. Using clinical and radiological criteria, 19 results were considered excellent to good. One patient with a residual deformity was revised with a total knee and 1 patient with an anatomical result had arthritic pain in the knee operated on. Arthroscopic reduction had no advantages over reduction under fluoroscopic control in this study. The specific value of the technically demanding endoscopic procedure should be questioned, as percutaneous reduction under fluoroscopic control may achieve comparable results in the majority of these cases.
对33例患者进行回顾性评估,以探讨闭合复位技术在胫骨平台骨折中的作用。这些患者主要为B型骨折(AO分类),采用关节镜下复位技术治疗(n = 10)或在透视控制下复位(n = 23)并经皮螺钉固定。对平均随访34个月(最短1年)的21例患者进行了复查。根据临床和影像学标准,19例结果被评为优至良。1例残留畸形患者接受了全膝关节翻修手术,1例解剖复位患者在手术膝关节出现了关节炎疼痛。在本研究中,关节镜下复位与透视控制下复位相比并无优势。鉴于在大多数此类病例中,透视控制下的经皮复位可能取得类似结果,技术要求较高的内镜手术的具体价值值得质疑。