【摘要】 目的 总结和探讨膝关节镜治疗胫骨平台骨折的临床效果。方法 27例患者的回顾性研究，男17例，女10例；年龄23～77岁，平均47.7岁；直接暴力16例，间接暴力11例，均为平台塌陷骨折，手术时间为伤后6h～2周。Ⅰ型3例，Ⅱ型10例，Ⅲ型4例，Ⅳ型6例，Ⅴ型2例，Ⅵ型2例。采用关节镜检查，根据镜下所见骨折线的位置，在相应胫骨平台的上端切口，关节镜监视下垫起胫骨平台关节面、支撑和填塞植骨，支撑钢板或钛板固定。根据关节镜所见、骨折愈合情况、功能恢复情况分析效果。结果 术后随访3～6个月，平均4.7个月，均达到骨性愈合，X线片显示关节面光滑，自主活动功能基本正常，恢复日常工作和生活。结论 膝关节镜辅助治疗胫骨平台骨折损伤小、观察关节面准确、可同时治疗关节内的其他病变、有利于早期恢复功能，减少后遗症和并发症，尤其适用于老年人，是一种值得推广的技术。

    【关键词】 胫骨平台；关节镜检查；骨折

    Treatment of tibial plateau fractures assisted with knee arthroscopy

    XU Xiao-feng,LI Ming.Department of Orthopaedics,Dalian No2 Hospital,Liaoning 116011,China

    【Abstract】 Objective To summary and explore the clinical results of tibial plateau fractures treatment assisted with arthroscopy.Methods 27 patients suffered from tibial plateau fractures were treated with assisted arthroscopy.The age of the patients was from 23 to 77 years with an average of 47.7 years.There was 17 males and 10 females.Direct violence was 16 cases,indirect violence was 11 cases.All the fractures were depression type,Type Ⅰ 3 cases,type Ⅱ 10 cases,type Ⅲ 4 cases,type Ⅳ 6 cases,type Ⅴ 2 cases,type Ⅵ 2 cases.The duration from injury to surgery was from 6 hours to 2 weeks.The treatment results were evaluated with respect to arthroscopical findings,the fracture union and the postoperative function.Results The patients were followed up 3～6 months with an average of 4.7 months postoperatively.All the patients obtained fracture union with a smooth joint surface on X-rays.The motion of the knee joint achieved nearly to their normal active range,all the patients were nearly recovery to their normal livelihood and works.Conclusion The treatment of tibial plateau fracture assisted with knee arthroscopy is a less traumatic procedure with good results.It can observe the knee joint accurately,it also can treat other disorders of the joint.This methods is profitable for soonly recovery,less complication and sequela.And has been shown to be highly efficient in the treatment of tibial plateau fractures in the elderly.This operation is worth to be advocated. ......