Xu Lei, Zhu Wanbo, Xie Kai, Liu Lei, Zhang Xianzuo, Yang Jiazhao, Wang Xujin, Fang Shiyuan
Department of Orthopaedics, The First Affiliated Hospital of University of Science and Technology of China.
Department of Orthopaedics, Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei, People's Republic of China.
Medicine (Baltimore). 2020 Jul 10;99(28):e21234. doi: 10.1097/MD.0000000000021234.
Traditional intramedullary nailing (IMN) for tibial shaft fractures through an infrapatellar approach is typically performed in the supine position and requires a specially designed operative table and an experienced assistant throughout the surgery. We attempted to perform IMN for tibial fractures in the lateral decubitus position to make the process easier both for surgeons and radiographers.
A total of 36 tibial IMN procedures were performed with the patient in the lateral position from May 1, 2014 to April 30, 2016. The technical feasibility and early results were evaluated.
The mean time to complete the nailing procedure during surgery was 78.4 ± 1.1 min. The mean intraoperative time for fluoroscopy was 36.7 ± 1.1 min. No radiographic angular malalignment or bone non-union was reported. No surgical site infections or other surgery-related complications occurred in our series.
Tibial IMN through an infrapatellar approach in the lateral decubitus position may be a valuable alternative as it simplifies the procedure for both surgeons and radiographers. This technique is highly effective for surgical operation and fluoroscopy compared to traditional supine position. This technique also seems to provide satisfactory clinical and radiographic outcomes in our preliminary clinical outcomes.
传统的经髌下入路胫骨干骨折髓内钉固定术（IMN）通常在仰卧位进行，手术全程需要特制的手术台和经验丰富的助手。我们尝试在侧卧位进行胫骨干骨折的IMN，以使手术过程对外科医生和放射技师来说都更简便。
2014年5月1日至2016年4月30日期间，共对36例患者在侧卧位下行胫骨髓内钉固定术。评估该技术的可行性及早期结果。
手术中完成髓内钉固定术的平均时间为78.4±1.1分钟。术中透视的平均时间为36.7±1.1分钟。未报告有影像学角度畸形或骨不连。本系列中未发生手术部位感染或其他与手术相关的并发症。
侧卧位经髌下入路胫骨髓内钉固定术可能是一种有价值的替代方法，因为它简化了外科医生和放射技师的操作流程。与传统仰卧位相比，该技术在手术操作和透视方面都非常有效。在我们的初步临床结果中，该技术似乎也能提供令人满意的临床和影像学结果。
