髌上入路髓内钉治疗胫骨多段骨折  

Suprapatellar approach intramedullary nail for treatment of multiple tibial fractures

作　　者：钟海波 郭祥[1] 刘亦恒[1] ZHONG Hai-bo;GUO Xiang;LIU Yi-heng(Dept of Orthopaedics,Haikou Hospital Affiliated to Xiangya Medical College,Central South University,Haikou,Hainan 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院骨科,海南海口570208

出　　处：《临床骨科杂志》2021年第3期439-441,共3页Journal of Clinical Orthopaedics

基　　金：海南省卫健委科教项目(编号:18A200115)。

摘　　要：目的探讨髌上入路髓内钉治疗胫骨多段骨折的临床疗效。方法采用髌上入路髓内钉治疗25例胫骨多段骨折患者。记录手术时间、术中出血量、骨折愈合时间、并发症情况。末次随访时采用Johner-Wruhs评分标准评价临床疗效。结果患者均获得随访,时间9~18(16.23±1.05)个月。手术时间40~130(60.21±8.45)min,术中出血量60~230(80.32±10.15)ml。术后2周切口均正常愈合。未发生神经、血管损伤等并发症。骨折愈合时间3~9(4.40±1.44)个月。末次随访时采用Johner-Wruhs评分标准评价临床疗效:优20例,良4例,可1例,优良率为24/25。结论髌上入路髓内钉是治疗胫骨多段骨折的一种有效的方法,但需术前全面检查,把握好手术指针。Objective To investigate the clinical efficacy of intramedullary nail with suprapatellar approach in multiple tibial fractures.Methods The 25 patients of multiple tibial fractures were treated with intramedullary nail via suprapatellar approach.The operative time,intraoperative bleeding volume,fracture healing time and complication situation were recorded.At last follow-up,Johner-Wruhs score criterion was used to assess the clinical efficacy.Results All cases were followed up for 9~18(16.23±1.05)months.The operative time was 40~130(60.21±8.45)min,the intraoperative bleeding volume was 60~230(80.32±10.15)ml,all incisions were healed normally within 2 weeks,there was no complication of blood vessel or nerve injury.The fracture healing time was 3~9(4.40±1.44)months.At the last follow-up,the assessment result of Johner-Wruhs score criterion was that 20 cases were excellent,4 good,1 fair,with the excellent-good rate of 24/25.Conclusions Intramedullary nail through suprapatellar approach is an effective method to treat multiple tibial fractures,but which needs the preoperative comprehensive examination,grasps the surgery indication well.

关 键 词：胫骨多段骨折 胫骨髓内钉 髌上入路 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]