髌上入路和髌下入路髓内钉内固定治疗胫骨骨折的效果  

Effect of Intramedullary Nail Internal Fixation with Suprapatellar Approach and Subpatellar Approach in the Treatment of Tibial Fracture

作　　者：张柏江[1] ZHANG Baijiang(Jingjiang People's Hospital,Jingjiang 214500,China)

机构地区：[1]靖江市人民医院,江苏靖江214500

出　　处：《中外医学研究》2024年第19期53-56,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨髌上入路和髌下入路髓内钉内固定治疗胫骨骨折的效果。方法:选取2019年1月—2023年10月靖江市人民医院收治的60例胫骨骨折患者为研究对象。根据随机抽签将其分为对照组和观察组,各30例。对照组给予髌下入路髓内钉内固定,观察组给予髌上入路髓内钉内固定。比较两组围手术期指标,术前及术后膝关节功能,并发症。结果:观察组手术时间及术后消肿时间、住院时间、骨折愈合时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组功能、活动度、肌力、屈曲畸形评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:治疗胫骨骨折可采取髓内钉固定术方式,选择髌上入路相较髌下入路效果更佳,可促进患者术后膝关节功能的恢复,且减少并发症。Objective:To explore the effect of intramedullary nail internal fixation with suprapatellar approach and subpatellar approach in the treatment of tibial fracture.Method:Sixty patients with tibial fracture admitted to Jingjiang People's Hospital from January 2019 to October 2023 were selected as the study objects.According to random drawing,they were divided into control group and observation group,with 30 cases in each group.The control group was given intramedullary nail internal fixation by subpatellar approach,and the observation group was given intramedullary nail internal fixation by suprapatellar approach.Perioperative indexes,preoperative and postoperative knee joint function and complications were compared between the two groups.Result:The surgery time,postoperative detumescence time,hospital stay time and fracture healing time in the observation group were shorter than those in the control group,and the intraoperative blood loss volume was less than that in the control group,the differences were statistically significant(P<0.05).At 3 months after surgery,the function,activity level,muscle strength and flexion deformity scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Intramedullary nailing fixation surgery method can be used to treat tibial fractures.The suprapatellar approach is more effective than the subpatellar approach,which can promote the recovery of knee joint function and reduce complications.

关 键 词：髓内钉内固定 胫骨骨折 髌上入路 髌下入路 膝关节功能 

分 类 号：R687.3[医药卫生—骨科学]