Xie Bing, Yang Chao, Tian Jing, Zhou Da-peng
Zhongguo Gu Shang. 2015 Oct;28(10):955-9.
To study the clinical efficacy of semiextended intramedullary nailing of the tibia using a suprapatellar approach for proximal tibial fractures.
From January 2013 to January 2014, a total of 16 patients with unilateral proximal tibial fractures, 14 males and 2 females, underwent closed reduction and internal fixation with TRIGEN™ META-NAIL™ via the suprapatellar approach. The average age was 42.2 years old (ranged, 26 to 57 years old). Radiographic and clinical follow-up examinations were performed at a minimum of 1 year after surgery. Measurements included surgery time, complications, bone healing time, tibial alignment, knee range of motion, pain scoring (visual analogue scale) and functional outcome (Lysholm knee score).
The average surgery time was (75.7±8.3) minutes (ranged, 65 to 95 minutes). No obvious complications were recorded. Average duration of follow-up was (15.6±8.1) months (ranged, 12 to 24 months). Fifteen patients attained radiological bone union for a mean time of (3.6±1.8) months (ranged, 3 to 5 months). At the final follow-up, all tibial alignments were good, and no patients complained of anterior knee pain. Mean arc of knee motion was (124.4±18.8) degrees for the affected extremity compared with (127.5±16.7) degrees for the contra-lateral knee. The total scores of Lysholm knee score ranged from 77 to 92, average 86.4±12.3.
For proximal tibial fractures,the semiextended intramedullary nailing technique via a suprapatellar approach can obtain satisfactory clinical outcomes with simplicity in reduction and fixation, minimal complications, and good recovery of limbs function.
探讨采用髌上入路的胫骨半扩髓髓内钉治疗胫骨近端骨折的临床疗效。
2013年1月至2014年1月，共16例单侧胫骨近端骨折患者，其中男性14例，女性2例，采用髌上入路，使用TRIGEN™ META-NAIL™进行闭合复位内固定。平均年龄42.2岁（范围26至57岁）。术后至少1年进行影像学和临床随访检查。测量指标包括手术时间、并发症、骨愈合时间、胫骨对线、膝关节活动范围、疼痛评分（视觉模拟评分）和功能结果（Lysholm膝关节评分）。
平均手术时间为(75.7±8.3)分钟（范围65至95分钟）。未记录到明显并发症。平均随访时间为(15.6±8.1)个月（范围12至24个月）。15例患者获得放射学骨愈合，平均时间为(3.6±1.8)个月（范围3至5个月）。在末次随访时，所有胫骨对线良好，无患者主诉膝关节前方疼痛。患侧膝关节平均活动弧为(124.4±18.8)度，对侧膝关节为(127.5±16.7)度。Lysholm膝关节评分总分范围为77至92分，平均86.4±12.3分。
对于胫骨近端骨折，采用髌上入路的胫骨半扩髓髓内钉技术在复位和固定方面操作简单，并发症少，肢体功能恢复良好，可获得满意的临床疗效。
