Comparative Effectiveness Research Of Tibial Plateau Fractures(schatzker, Ⅲ) Treatment With Arthroscopic Assisted Fixation By Guide Apparatus Versus Traditional Reduction Internal Fixation

Objective: Through pilot aided fixation under arthroscopy and traditional open reduction and internal fixation with two types of surgical treatment of tibial plateau Schatzker type III fracture, and compare the two kinds of operative methods of average operation time, length of hospital stay, postoperative incision size, scope of knee flexion, knee joint function of Hss score and postoperative complications, analysis of the clinical curative effects, to guide the operation.Methods: From September 2007 to September 2007 to choose our Schatzker III type, 41 cases of fracture of tibial plateau according to admission order randomly divided into A, B two groups, A group of 20 patients, 21 cases of group B, group A by pilot aided fixation under arthroscopy surgery, group B with traditional open reduction and internal fixation surgery. Comparative evaluation the clinical data of two groups of cases and postoperative recovery.Results: All surgery performed by the same group of physicians. The average operation time was 94.05 ± 14.43 min group A, group B was 112.09 ±17.12 min. A group of average hospital stay was 7.12 ± 1.05 d, group B was 14.05 ±1.19 d; Group A average incision size was 6.53 ±1.12 cm, group B was 13.89 ± 1.05 cm, two groups of cases the average operation time, average hospitalization time and incision size was statistically difference(p < 0.05); All cases received follow-up, knee flexion range atthe time of 24 months follow-up after an average of 125.13±15.41 degrees of group A and group B was 108.43 ±12.65 degrees, two groups of data statistically significant(p < 0.05); 24 months after knee joint function of HSS score in group A with an average of 85.83 ± 8.91 points, group B was 76.47 ± 8,01 points, two groups of data statistically significant(p < 0.05). Postoperative complications: group A with 1 case of postoperative leg swelling, improved after treatment does not appear postoperative complications such as postoperative infection, knee joint stiffness, joint pain. Group B of postoperative infection in 1 case, knee joint stiffness in 3 cases, joint pain in 5 cases, postoperative complications were more significant differences between the two groups(p < 0.05).Conclusion: Guide under arthroscopy assisted Schatzker III type of tibial plateau fractures treated with shorter operation time and hospital stay, and the advantages of small incision, and less postoperative complications, can obtain the good function of knee joint, should be worth clinical application.