目的：应用创伤关节镜下手术治疗胫骨后侧平台骨折患者，观察分析其临床疗效。方法以本院2012年4月至2013年2月接治的24例胫骨后侧平台骨折患者作为总研究对象，然后随机分为观察组和对照组，其中观察组采用后侧内或外入路内固定法进行治疗，而对照组则在创伤关节镜的辅助下进行治疗，术后进行1～2年的随访，平均12个月，按HSS和Rasmussen的评分标准分别对患者膝关节恢复情况和术后复位满意程度进行评分，比较两组的临床疗效。结果根据膝关节功能评价体系HSS评分发现，术后12个月观察组HSS评分为86.73±4.3，对照组为91.21±3.8，且P＜0.05，说明对照组较观察组恢复效果更好；根据Rasmussen的评分标准对术后患者进行骨骼复位满意程度调查，观察组优良率（83.3%）明显低于对照组（91.7%）。结论关节镜用于治疗特殊的胫骨后侧平台骨折，具有观看视野广阔、低损伤、实时监控等优点，并且术后对骨骼的复位效果较好，无不良并发症出现，因此是临床治疗此类骨折的良好方法。%Objective To observed and analysed the clinical efifcacy, we applied the arthroscopy to treat the patients with posterior tibial plateau fracture. Methods We selected 24 cases patients who had posterior tibial plateau fracture in our hospital from April 2012 to February 2013, and then randomly divided into observation group and control group, observation group used posterior approach for the treatment of posterior tibial plateau fracture, while the control group chose the means of arthroscopic to treatment, patients of two groups were followed up for 1 ~ 2 years, an average of 12 months, knee-joint function and patients’ satisfaction with fracture reduction were evaluated by HSS and Rasmussen radiological standard. Results According to the HSS evaluation system of knee-joint function score, we found that the score of observation group was 86.73±4.3 after 12 months, while control group’s score was 91.21±3.8, P < 0.05, so the observation group was better than the control group;according to Rasmussen radiological standard, we found that the patients’ satisfaction of observation group was 83.3%, which was lower than the control group. Conclusions Arthroscopic used for treating speciifc tibial plateau fractures with posterior is very well. It has many advantages, such as wide ifeld of view, small degree of injury, real-time monitoring, better effect of restoration, no adverse complications. Therefore arthroscopy treating tibial posterior plateau fracture is a good means.
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