髌上入路胫骨髓内钉技术治疗胫骨近端关节外骨折的效果  

Treatment of Proximal Tibial Extra-articular Fractures with Suprapatellar Approach and Tibial Intramedullary Nail Technique

作　　者：陈春冉 王万骥 黄润堂 李春广 高凯 张霏 李生玉 CHEN Chunran;WANG Wanji;HUANG Runtang;LI Chunguang;GAO Kai;ZHANG Fei;LI Shengyu(Department of Trauma and Orthopedics,Nanyang TCM Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中医院创伤骨科,河南南阳473000

出　　处：《河南医学研究》2024年第5期851-854,共4页Henan Medical Research

摘　　要：目的探讨髌上入路胫骨髓内钉技术治疗胫骨近端关节外骨折的临床效果。方法采用随机对照试验研究,依据随机数字表法将南阳市中医院2019年3月至2022年12月收治的60例胫骨近端关节外骨折患者分为A组和B组,各30例。A组接受常规髌下入路胫骨髓内钉治疗,B组接受髌上入路胫骨髓内钉技术治疗,比较两组手术相关指标、疼痛程度、膝关节功能,并统计两组并发症发生情况。结果B组手术时间短于A组,术中透视次数少于A组(P<0.05),但两组术中出血量、完全负重时间、骨折愈合时间、住院时间比较,差异无统计学意义(P>0.05);术后6个月时,B组视觉模拟评分法(VAS)评分低于A组,Lysholm膝关节评分(LKS)评分、膝关节屈曲活动度均高于A组(P<0.05);B组术后并发症发生率低于A组(P>0.05)。结论髌上入路胫骨髓内钉技术治疗胫骨近端关节外骨折可缩短手术时间,减少术中透视次数,同时可减轻患者术后疼痛程度,促进患者膝关节功能的恢复,降低术后并发症发生率。Objective To explore the clinical effect of suprapatellar approach tibial intramedullary nail technology in the treatment of proximal tibial extra-articular fractures.Methods A randomized controlled trial was conducted.According to the random number table method,60 patients with proximal tibial extra-articular fractures admitted to Nanyang Traditional Chinese Medicine Hospital from March 2019 to December 2022 were divided into group A and group B,with 30 cases in each group.Group A was treated with conventional infrapatellar tibial intramedullary nailing,while group B was treated with suprapatellar tibial intramedullary nailing.The surgical related indicators,pain level,knee joint function,and incidence of complications were compared between the two groups.Results The surgical time in group B was shorter than that in group A,and the number of intraoperative fluoroscopy was less than that in group A(P<0.05).However,there were no differences in intraoperative bleeding,complete weight-bearing time,fracture healing time,and hospital stay between the two groups(P>0.05).At 6 months after surgery,the visual analogue scale(VAS)score in group B was lower than that in group A,while the Lysholm knee joint score(LKS)score and knee flexion range of motion were higher than those in group A(P<0.05).The incidence of postoperative complications in group B was lower than that in group A(P>0.05).Conclusion The suprapatellar approach with tibial intramedullary nail technology can shorten the surgical time,reduce the number of intraoperative fluoroscopy,alleviate postoperative pain,promote the recovery of knee joint function,and reduce the incidence of postoperative complications in the treatment of proximal tibial extra-articular fractures.

关 键 词：胫骨近端关节外骨折 髌上入路 髌下入路 胫骨髓内钉 

分 类 号：R683[医药卫生—骨科学]