髓内钉内固定治疗胫骨骨折髌上入路和髌下入路的临床效果及预后研究  

Study on clinical effect and prognosis of intramedullary nail fixation via suprapatellar versus infrapatellar approaches in the treatment of tibial fractures

作　　者：刘瑞仁 谢皇林 刘忠国[1] 林建春[1] LIU Rui-ren;XIE Huang-lin;LIU Zhong-guo(Xiamen Third Hospital,Xiamen 361100,China)

机构地区：[1]厦门市第三医院,361100

出　　处：《中国现代药物应用》2023年第12期64-66,共3页Chinese Journal of Modern Drug Application

摘　　要：目的观察髓内钉内固定治疗胫骨骨折髌上入路和髌下入路的临床效果及预后。方法60例胫骨骨折患者为研究对象,以随机数字表法分为髌下组与髌上组,各30例。髌上组采用髌上入路髓内钉内固定治疗,髌下组采用髌下入路髓内钉内固定治疗。比较两组临床指标,术后1、3、6、10个月疼痛及膝关节功能评分。结果髌上组患者手术时间(117.36±31.31)min及住院时间(11.31±2.30)d均短于髌下组的(134.69±35.22)min、(15.76±3.15)d,透视次数(16.33±2.87)次少于髌下组的(21.77±3.09)次,差异有统计学意义(P<0.05)。术后3、6、10个月,两组疼痛评分均低于本组术后1个月,且髌上组疼痛评分分别为(2.41±0.67)、(1.77±0.41)、(0.69±0.18)分,均低于髌下组的(2.75±0.62)、(2.05±0.36)、(1.05±0.27)分,差异均有统计学意义(P<0.05)。术后3、6、10个月,两组膝关节功能评分均高于本组术后1个月,且髌上组膝关节功能评分分别为(83.75±4.72)、(87.97±4.61)、(92.69±3.18)分,均高于髌下组的(80.93±5.27)、(84.85±4.26)、(89.25±5.37)分,差异均有统计学意义(P<0.05)。结论胫骨骨折患者接受髓内钉内固定治疗时,应用髌上入路,可明显缩短手术时间及住院时间,减少透视次数,术后膝关节功能评分更高,减轻术后疼痛效果更明显,优于髌下入路。Objective To observe the clinical effect and prognosis of intramedullary nail fixation via suprapatellar versus infrapatellar approaches in the treatment of tibial fractures.Methods A total of 60 patients with tibial fractures were randomly divided into infrapatellar group and suprapatellar group,with 30 cases in each group.The suprapatellar group was treated with intramedullary nail fixation via the suprapatellar approach,and the infrapatellar group was treated with intramedullary nail fixation via the infrapatellar approach.The clinical indicators,pain and knee joint function scores at 1,3,6 and 10 months after surgery were compared between the two groups.Results The operative time of(117.36±31.31)min and hospitalization time of(11.31±2.30)d in the suprapatellar group were shorter than those of(134.69±35.22)min and(15.76±3.15)d in the infrapatellar group;the fluoroscopy times of(16.33±2.87)times in suprapatellar group were less than that of(21.77±3.09)times infrapatellar group;the differences were statistically significant(P<0.05).At 3,6 and 10 months after surgery,the pain scores in both groups were lower than those in this group at 1 month after surgery;the pain scores were(2.41±0.67),(1.77±0.41)and(0.69±0.18)points in the suprapatellar group,which were lower than those of(2.75±0.62),(2.05±0.36)and(1.05±0.27)points in the infrapatellar group;the differences were statistically significant(P<0.05).At 3,6 and 10 months after surgery,the knee joint function scores in both groups were higher than those in this group at 1 month after surgery;the knee joint function score were(83.75±4.72),(87.97±4.61)and(92.69±3.18)points in the suprapatellar group,which were higher than those of(80.93±5.27),(84.85±4.26)and(89.25±5.37)points in the infrapatellar group;the differences were statistically significant(P<0.05).Conclusion Intramedullary nail fixation vai suprapatellar approach can significantly shorten the operative time and hospitalization time,reduce the fluoroscopy times,and improve the score of knee

关 键 词：髓内钉 内固定治疗 胫骨骨折 髌上入路 髌下入路 

分 类 号：R687.3[医药卫生—骨科学]