Analysis Of The Efficacy Of Arthroscopic Treatment Of Tibial Plateau Fractures

Objective:To analyze the clinical efficacy of arthroscopic treatment of tibial plateau fractures.Method:72 patients with tibial plateau fractures were admitted to our hospital from October 2015 to November 2017 and was divided into arthroscopically assisted and fixed group A(n=36).14 patients were injured due to motor vehicle accident and 10 cases of fall from high altitude.There were 8 cases of severe sports injuries and 4 cases of other injuries;20 cases of left knee involvement and 16 cases of right knee joint;15 cases of Schatzker fracture type I,12 cases of type II,7 cases of type III,2 cases of type IV;involved other soft tissue injuries of the knee at the same time,12 cases of meniscus injury,7 cases of cruciate ligament injury,4 cases of medial collateral ligament injury,and 5 cases of cartilage injury;group B was treated with traditional open reduction and internal fixation(n=36 cases),12 cases were injured due to motor vehicle accident,10 cases were injured by falling from a height,8 cases were severe sports injuries,6 cases were other injuries,in 18 cases the left knee was involved,and right knee was involved in 18 other cases;and 14 cases of Schatzker fracture type I,11 cases of type II,9 cases of type III,and 2 cases of type IV.At the same time,it involved other soft tissue injuries of the knee.There were 10 cases of meniscus injury,8 cases of cruciate ligament injury,3 cases of medial collateral ligament injury and 7 cases of cartilage injury.The general clinical data,relevant intraoperative data,and hospital-related data were compared between the two groups.Pain scores were scored on day 1,3 and 5 postoperatively using VAS scores,and on day 3 and 2 weeks after surgery,Rasmussen knee scores were used to evaluate the knee function.Also at 3,6 and 12 months after surgery knee function was evaluated using Rasmussen knee scores.Lysholm knee scores were used to score the knee joints at the 2nd week,3rd,6th,and 12th month postoperatively.The excellent rate of Rasmussen score and Lysholm score at the 12th month after operation were compared.Results:1.There was no statistically significant difference in the age,gender,affected side of the affected limb,cause of injury,type of fracture,knee joint injury,soft tissue site,and hospitalization days(P>0.05).2.The incision length(mm)and the duration of intraoperative tourniquet application(min)were statistically significant between the two groups(all P<0.05).3.The pain scores of VAS on the 1st,3rd,and 5th day after operation in group A were significantly higher than those in group B(P<0.05);the Rasmussen’s knee score in group A were significantly higher than those in group B on the 3rd day and 2nd week,and 3,6and 12 months after operation(P<0.05).The excellent rate of group A was significantly better than that of group B at the 12th month after surgery(P<0.05).The Lysholm knee function scores of group A at the 2nd week and on 3,6,and 12 months after operation was significantly higher than those of group B(P<0.05).The excellent rate of the 12th postoperative month was significant.The results in group A were significantly better than those in group B,with statistical significance(P<0.05).Conclusion:Treatment of tibial plateau fractures with the aid of minimally invasive arthroscopic techniques,with magnification under the microscope,fine operation under direct vision,and the advantages of minimal trauma,avoidance of switching the capsule and the recovery of the knee joint function is good.It is worth of further promotion and application in the clinic.