Tang Hui-Bin, Sun Zhen-Guo, Weng Wei, Xu Xu-Chun, Min Ji-Kang
Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, Huzhou 313000, Zhejiang, China.
Zhongguo Gu Shang. 2021 Dec 25;34(12):1165-70. doi: 10.12200/j.issn.1003-0034.2021.12.014.
To investigate the short-term effect of suprapatellar interlocking intramedullary nail in the treatment of tibial fractures.
Eighty patients with tibial fractures treated from January 2016 to June 2018 were treated with interlocking intramedullary nail, who were divided into observation group (suprapatellar approach) and control group (patellar ligament approach) according to different surgical approaches. There were 40 cases in the observation group, including 28 males and 12 females, aged 28 to 67 years with a mean of (46.70±10.34) years. There were 40 cases in the control group, including 30 males and 10 females, aged 31 to 69 years with a mean of(49.38±10.74) years. The operation time, incision length, intraoperative C-arm X-ray fluoroscopy times, intraoperative blood loss, fracture healing time, postoperative active straight leg raise (SLR) time, hospital stay, visual analogue scale (VAS), knee pain rate and postoperative Hospital for Special Surgery (HSS) score were recorded and compared between two groups.
All the patients were followed up, and the duration ranged from 19 to 38 months, with an average of(24.60±4.52) months. In the observation group, the operation time was(53.83± 7.01) min;the incision length was (3.98±0.83) cm;the number of intraoperative C-arm X-ray fluoroscopy was (18.90±1.75) times;the fracture healing time was (10.03±0.89) weeks;the postoperative active SLR time was (1.19±0.25) days;and the hospital stay was(6.73±1.06) days. The above indexes were better than those in the control group (<0.05). In the latest follow-up, 34 cases got an excellent result, 5 good, 1 fair and 0 poorin the observation group. In the control group, 25 cases got an excellent result, 9 good, 6 fair and 0 poor. The curative effect of the observation group was better than that of the control group(< 0.05).
The treatment of tibial fractures with suprapatellar interlocking intramedullary nail has the advantages of less trauma and better recovery of knee function. It can obtain more satisfactory clinical results and can be further widely used.
探讨髌上入路交锁髓内钉治疗胫骨骨折的短期疗效。
选取2016年1月至2018年6月收治的80例胫骨骨折患者，均采用交锁髓内钉治疗，根据手术入路不同分为观察组（髌上入路）和对照组（髌韧带入路）。观察组40例，男28例，女12例，年龄28～67岁，平均（46.70±10.34）岁。对照组40例，男30例，女10例，年龄31～69岁，平均（49.38±10.74）岁。记录并比较两组患者的手术时间、切口长度、术中C型臂X线透视次数、术中出血量、骨折愈合时间、术后主动直腿抬高（SLR）时间、住院时间、视觉模拟评分法（VAS）、膝关节疼痛发生率及术后美国特种外科医院（HSS）评分。
所有患者均获随访，随访时间19～38个月，平均（24.60±4.52）个月。观察组手术时间为（53.83±7.01）min，切口长度为（3.98±0.83）cm，术中C型臂X线透视次数为（18.90±1.75）次，骨折愈合时间为（10.03±0.89）周，术后主动SLR时间为（1.19±0.25）d，住院时间为（6.73±1.06）d。上述指标均优于对照组（P<0.05）。末次随访时，观察组优34例，良5例，可1例，差0例；对照组优25例，良9例，可6例，差0例。观察组疗效优于对照组（P<0.05）。
髌上入路交锁髓内钉治疗胫骨骨折具有创伤小、膝关节功能恢复好等优点，可获得更满意的临床效果，值得进一步推广应用。
