Department of Orthopedics, No.971 Hospital of the PLA Navy, 22 Ming-Jiang Road, 266071, Qingdao city, PR China.
BMC Musculoskelet Disord. 2021 Jan 6;22(1):25. doi: 10.1186/s12891-020-03883-1.
The conventional infrapatellar approach to intramedullary nailing of tibial fractures adopts the supine high-flexion knee position. However, this has disadvantages including difficulty in obtaining the proximal tibial anteroposterior view during intraoperative fluoroscopy, prolonged duration of fluoroscopy. Accordingly, the present study investigated the utility of the lateral position in the infrapatellar approach to intramedullary nailing of tibial shaft fractures.
The present study was a retrospective analysis of 112 patients who sustained closed tibial shaft fractures and treated with intramedullary nailing via the infrapatellar approach. Patients were divided into two groups according to surgical position: lateral or supine. The demographic and clinical data were collected and analyzed.
There were 54 patients in the lateral and 58 in the supine position groups. The duration of surgery and fluoroscopy was shorter in the lateral group than the supine group (p < 0.05). Blood loss during surgery was lower in the lateral compared with supine position group (p < 0.05). The malunion rate was lower in the lateral position group as compared with the supine position group (p < 0.05); moreover, fewer surgical assistants were needed than in the supine group (p < 0.05). There were no significant differences in fracture healing time, other complications between the two groups (p > 0.05).
The lateral position was a more convenient choice for intramedullary nailing of tibial shaft fractures via infrapatellar approach.
传统的经髌下入路髓内钉治疗胫骨骨折采用仰卧位高屈曲膝关节位。然而，这种方法存在一些缺点，包括术中透视时难以获得胫骨近段前后位，透视时间延长。因此，本研究探讨了髌下入路经皮微创钢板内固定治疗胫骨骨折时采用侧卧位的效果。
本研究回顾性分析了 112 例闭合性胫骨骨折患者，采用经髌下入路髓内钉治疗。患者根据手术体位分为侧卧位和仰卧位两组。收集并分析了两组患者的一般资料和临床资料。
侧卧位组 54 例，仰卧位组 58 例。侧卧位组手术时间和透视时间均短于仰卧位组（p<0.05）。侧卧位组术中出血量低于仰卧位组（p<0.05）。侧卧位组的畸形愈合发生率低于仰卧位组（p<0.05）；此外，侧卧位组所需的手术助手人数少于仰卧位组（p<0.05）。两组骨折愈合时间、其他并发症发生率比较差异均无统计学意义（p>0.05）。
对于经髌下入路髓内钉治疗胫骨骨折，侧卧位是一种更方便的选择。
