Clinical observation of arthroscopic assisted precise prying reduction and internal fixation combined with bone grafting for the treatment of Schatzker type II-III tibial plateau fractures
关节镜辅助下精确撬拨复位内固定结合植骨术治疗SchatzkerⅡ-Ⅲ型胫骨平台骨折的临床观察

摘要

目的 评估关节镜辅助下精确撬拨复位内固定结合植骨术治疗SchatzkerⅡ-Ⅲ型胫骨平台骨折的临床效果。方法 回顾性分析2017年8月至2025年12月收治的100例患者，随机分为A组（50例，行关节镜辅助撬拨复位内固定结合植骨术）和H组（50例，采用传统切开复位内固定结合植骨术治疗、植骨内固定术）。比较两组手术指标、血清炎性指标、膝关节功能及并发症。结果 A组手术时间、骨折愈合时间、切口愈合时间更短，术中出血更少（P<0.05）。术后两组炎性因子均升高，但A组白细胞介素‑6（IL‑6）、超敏C‑反应蛋白（Hs‑CRP）水平低于H组（P<0.05）。术后膝关节功能与自理能力改善A组更显著（P<0.05）。A组并发症发生率（4.00%）低于H组（16.00%）（P<0.05）。结论 关节镜辅助撬拨复位内固定结合植骨术治疗SchatzkerⅡ-Ⅲ型胫骨平台骨折效果更优，值得推广。

Abstract

Objective To evaluate the clinical efficacy of arthroscopic assisted precise prying reduction and internal fixation combined with bone grafting in the treatment of Schatzker type II-III tibial plateau fractures.
Methods A retrospective analysis was conducted on 100 patients admitted from August 2017 to December 2025. They were randomly divided into Group A (50 cases, treated with arthroscopic assisted prying reduction and internal fixation combined with bone grafting) and Group H (50 cases, treated with traditional meniscal incision for fracture reduction and internal fixation with bone grafting). Compare two groups of surgical indicators, serum inflammatory indicators, knee joint function, and complications.
Results Group A had shorter surgical time, fracture healing time, incision healing time, and less intraoperative bleeding (P<0.05). After surgery, both groups of inflammatory factors increased, but the levels of Interleukin‑6 (IL‑6) and high‑sensitivity C‑reactive protein (Hs‑CRP) in group A were lower than those in group H (P<0.05). The postoperative improvement in knee joint function and self-care ability was more significant in Group A (P<0.05). The incidence of complications in Group A (4.00%) was lower than that in Group H (16.00%) (P<0.05).
Conclusion   Arthroscopy assisted prying reduction and internal fixation combined with bone grafting is more effective in treating Schatzker type II-III tibial plateau fractures and is worth promoting.