膝关节镜辅助下髌上入路髓内钉治疗胫骨干骨折的临床应用  

Clinical Application of Knee Arthroscopy-assisted Suprapatellar Intramedullary Nail in the Treatment of Tibial Shaft Fracture

作　　者：周强 黄江飞 张志强 谢磊 李泉胜 ZHOU Qiang;HUANG Jiangfei;ZHANG Zhiqiang;XIE Lei;LI Quansheng(Department of Orthopedics,Guixi People's Hospital,Guixi 335400,China;不详)

机构地区：[1]贵溪市人民医院骨科,江西贵溪335400

出　　处：《中国医学创新》2025年第6期80-84,共5页Medical Innovation of China

基　　金：鹰潭市科技指导性科技计划项目(2023-9-33153)。

摘　　要：目的:探究在膝关节镜辅助的前提下采用髌上入路髓内钉治疗对胫骨干骨折的临床应用价值。方法:回顾性选取2021年1月—2023年5月70例在贵溪市人民医院进行髌上入路髓内钉治疗的胫骨干骨折患者为研究对象,根据治疗方法分为对照组和联合组,各为35例。对照组患者采用髌上入路髓内钉进行治疗,联合组患者在对照组的治疗方案上增加膝关节镜辅助治疗。采用视觉模拟评分法(VAS)评估患者的疼痛程度,膝关节功能通过美国特种外科医院(HSS)膝关节功能评分、Lysholm膝关节评分评估,比较两组患者的临床指标(手术时间、住院时间、术中失血量)、术后1、3、6个月的VAS评分和膝关节功能。结果:联合组的临床指标较对照组均减少,差异均有统计学意义(P<0.05)。两组患者术后第3、6个月的VAS评分均下降,且术后6个月均低于术后3个月,术后3个月均低于术后1个月,联合组均低于对照组,差异均有统计学意义(P<0.05)。联合组患者术后1、3、6个月的HSS评分、Lysholm评分均高于对照组,且两组HSS评分、Lysholm评分术后1个月、术后3个月及术后6个月逐渐升高,差异均有统计学意义(P<0.05)。结论:膝关节镜辅助下髌上入路髓内钉治疗胫骨干骨折可有效改善患者的临床指标,降低患者的疼痛情况,提高患者的膝关节功能,具有较好的应用价值。Objective:To explore the clinical application value of suprapatellar approach intramedullary nail in the treatment of tibial shaft fracture with the assistance of knee arthroscopy.Method:A total of 70 patients who received intramedullary nail treatment with lower suprapatellar approach for tibial shaft fracture in Guixi People's Hospital from January 2021 to May 2023 were retrospectively selected as the study objects,and they were divided into control group and combined group according to treatment methods,with 35 cases in each group.The control group was treated with intramedullary nailing through suprapatellar approach,and the combined group was added with knee arthroscopy.Visual analogue scale(VAS)was used to evaluate the pain degree of patients.Knee function was evaluated by hospital for special surgery(HSS)knee function score and Lysholm knee joint score.The clinical indicators(operation time,hospital stay,intraoperative blood loss),VAS scores at 1 month,3 and 6 months after surgery and knee function were compared between the two groups.Result:The clinical indicators of the combined group were significantly lower than those of the control group(P<0.05).The VAS scores of the two groups decreased at 3 and 6 months after operation,and the VAS scores at 6 months after operation were lower than those at 3 months after operation,and the VAS scores at 3 months after operation were lower than those at 1 month after operation,and the VAS scores in the combined group were lower than those in the control group,the differences were statistically significant(P<0.05).The HSS scores and Lysholm scores of the combined group at 1 month,3 and 6 months after operation were higher than those of the control group,and the HSS scores and Lysholm scores of the two groups gradually increased at 1 month,3 months and 6 months after operation,the differences were statistically significant(P<0.05).Conclusion:Knee arthroscope-assisted suprapatellar intramedullary nail in the treatment of tibial shaft fracture can effectively improve the

关 键 词：膝关节镜 髌上入路髓内钉 胫骨干骨折 临床指标 膝关节功能 

分 类 号：R687.3[医药卫生—骨科学]