Fu Beigang
Department of Orthopedics, Zhoupu Hospital, Pudong New Area, Shanghai 201318, China.
Indian J Orthop. 2016 May-Jun;50(3):283-9. doi: 10.4103/0019-5413.181795.
Intramedullary nailing is an effective approach for treatment of diaphyseal tibial fractures. However, infrapatellar intramedullary nailing can easily cause angulation and rotation displacement at the fracture ends and increase risk of postoperative infection. Intramedullary nailing via the suprapatellar approach was proved with good reduction and fixation. We used locked intramedullary nailing for the treatment of tibial fractures via a suprapatellar approach in this study.
23 patients undergoing tibial fractures fixation by locked META intramedullary nailing via a suprapatellar approach were enrolled between June 2012 and October 2013. There were 18 males and 5 females. The average age was 35.5 years (range 18-60 years). The intraoperative data including operative time and blood loss and postoperative data consisting of hospital stays, fluoroscopy time, fracture healing time and complications were all recorded.
The average operative time, blood loss, fluoroscopy time and hospital stay were 78.2 ± 9.1 min, 90.4 ± 23.4 mL, 38.5 ± 6.5 s and 11 ± 3.4 days respectively. The mean followup period in all the patients was 15.5 months. Callus appeared in the patients at average 8 weeks after surgery. The mean knee and ankle range of motion were significantly improved at the last followup (P < 0.05). The average Hospital for Special Surgery and Olerud-Molander scores was 92 ± 4.3 points and 93.6 ± 3.9 points, respectively. No complications were observed.
Locked META intramedullary nail fixation via a suprapatellar approach is safe and effective for patients suffering from tibial fractures and earlier functional recovery.
髓内钉固定术是治疗胫骨干骨折的有效方法。然而,髌下髓内钉固定容易导致骨折端成角和旋转移位,并增加术后感染风险。经髌上入路髓内钉固定术已被证明具有良好的复位和固定效果。在本研究中,我们采用锁定髓内钉经髌上入路治疗胫骨骨折。
选取2012年6月至2013年10月间采用锁定META髓内钉经髌上入路治疗胫骨骨折固定的23例患者。其中男性18例,女性5例。平均年龄35.5岁(范围18 - 60岁)。记录术中数据,包括手术时间和失血量,以及术后数据,包括住院时间、透视时间、骨折愈合时间和并发症。
平均手术时间、失血量、透视时间和住院时间分别为78.2 ± 9.1分钟、90.4 ± 23.4毫升、38.5 ± 6.5秒和11 ± 3.4天。所有患者的平均随访期为15.5个月。术后平均8周患者出现骨痂。末次随访时膝关节和踝关节的平均活动范围显著改善(P < 0.05)。平均特种外科医院(HSS)评分和Olerud - Molander评分分别为92 ± 4.3分和93.6 ± 3.9分。未观察到并发症。
锁定META髓内钉经髌上入路固定术治疗胫骨骨折患者安全有效,且功能恢复较早。