Clinical Comparative Study Of Tibial Plateau Fractures Treatment With Arthroscopic Assisted Fixation Versus Traditional Reduction Internal Fixation

Objective:To evaluate arthroscopy assisted fixation versus traditional reduction and internal fixation of tibial plateau fractures Schatzker TypesⅡtoⅢ,analysis their characteristics respective at treating tibial plateau fracture,evaluate its efficacy differences,and provides a theoretical basis for the choice of the treatment methods.Method:Our hospital treated 50 patient with tibial plateau fractures of Schatzker typesⅡtoⅢin August 2008 to January 2010,which met the inclusion critera and exclusion criteria,and then all the patient were randomly divided into two groups:one group contain 20 patients was treated with arthroscopy assisted fixation (the arthroscopic group),another group contain 30 patients was operated by traditional reduction and internal fixation (the incision group).And then compared to assess the situation on two groups of patients,surgical data and postoperative functional recovery.Results: All the patients in two groups were followed up.The arthroscopy group which contain 20 patients obtained 11 excellent,7 good,2 fair and 0 poor,the rate of excellent heal was 90%,the effect were evaluated by HSS calcification.The incision group which contain 30 patients obtained 5 excellent,17 good,7 fair and 1 poor,the rate of excellent heal was 73.3%.At the same time,the arthroscopy group compared to the incision group had some benefits,such as the smaller incision length,shorter fracture healing time,better functional recovery between the two groups there were significant differences(P<0.05).but longer operative time,The score after 6 months: the arthroscopic group was 83.95±9.82 points,the incision group was 75.80±8.66 points,P<0.05,the two groups was significant difference;the knee flexion degree after 6 months:the arthroscopic group was 126.25±17.39°,the incision group was 111.33±14.79°,the two groups was significant difference(P<0.05).Postoperative complications:1 patient in the arthroscopic group had arthroscopic joint stiffness,no infection, postoperative pain, complications such as compartment syndrome the incision grop 3 patients had postoperative pain,7 cases of joint stiffness; two complications by X2 test, P<0.05, there are significant differences.Conclusion:The arthroscopy group in the treatment of tibial plateau fractures Schatzker typsⅡtoⅢbetter than the incision group,and beacause of the smaller incision length,shorter fracture healing time,a good postoperative functional recovery, fewer complications,it is worth in clinical promote.