Birlie Tsegalem, Biresaw Biniam, Yadeta Elias, Getachew Tamirat, Debella Adera, Eyeberu Addis
School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
School of Medicine, College of Health and Medical Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Orthop Res Rev. 2023 Apr 12;15:59-68. doi: 10.2147/ORR.S406176. eCollection 2023.
The incidence of femur fractures in young and elderly people has increased, particularly in countries with limited resources like Ethiopia. Intra-medullary nailing (IM) has been an effective and cost-effective method of treating long bone shaft fractures, but it can lead to complications such as knee pain.
This study aimed to evaluate knee pain and its associated factors following retrograde intramedullary nailing for femur fractures.
The study followed 110 patients diagnosed with femur fractures and treated with retrograde SIGN Standard Nail or Fin Nail from January 2020 to December 2022 at two hospitals in Ethiopia. The patients were followed up for at least 6 months, and data were collected from medical charts, patient interviews, and phone calls to patients who did not attend the follow-up appointment. Binary logistic regression analysis was used to identify factors associated with knee pain.
The study showed that 40 patients reported knee pain at 6-months follow-up, making a prevalence of 36.4%. Factors significantly associated with knee pain were a time of injury to nailing (AOR=4.23, 95% CI: 1.28-13.92), use of a screw to the medial cortex (AOR=9.30, 95% CI: 2.90-12.74), and fracture site (AOR= 2.67, 95% CI: 14.01-7.03). Specifically, the longer the time from injury to nailing, the higher the risk of knee pain. The use of a longer screw to the medial cortex and a fracture site were also positively associated with knee pain.
This study concludes that although retrograde intramedullary nail fixation is an effective method for femur fractures, it often results in knee pain. Approximately 4 of 10 patients suffered from knee pain in this study. Avoiding delayed surgical management and minimizing the use of prominent metalwork may reduce knee pain.
年轻人和老年人股骨骨折的发生率有所上升，在像埃塞俄比亚这样资源有限的国家尤其如此。髓内钉固定术（IM）一直是治疗长骨干骨折的一种有效且具有成本效益的方法，但它可能导致诸如膝关节疼痛等并发症。
本研究旨在评估股骨骨折逆行髓内钉固定术后的膝关节疼痛及其相关因素。
该研究追踪了2020年1月至2022年12月期间在埃塞俄比亚两家医院被诊断为股骨骨折并接受逆行SIGN标准钉或Fin钉治疗的110例患者。对患者进行了至少6个月的随访，数据从病历、患者访谈以及给未参加随访预约患者的电话中收集。采用二元逻辑回归分析来确定与膝关节疼痛相关的因素。
研究表明，在6个月的随访中有40例患者报告有膝关节疼痛，患病率为36.4%。与膝关节疼痛显著相关的因素有受伤至钉入的时间（比值比[AOR]=4.23，95%置信区间[CI]：1.28 - 13.92）、内侧皮质使用螺钉（AOR = 9.30，95% CI：2.90 - 12.74）以及骨折部位（AOR = 2.67，95% CI：14.01 - 7.03）。具体而言，受伤至钉入的时间越长，膝关节疼痛的风险越高。内侧皮质使用较长螺钉以及骨折部位也与膝关节疼痛呈正相关。
本研究得出结论，尽管逆行髓内钉固定术是治疗股骨骨折的一种有效方法，但它常常导致膝关节疼痛。在本研究中，约十分之四的患者患有膝关节疼痛。避免延迟手术治疗并尽量减少突出金属器械的使用可能会减轻膝关节疼痛。
