摘要
目的比较髌上入路与髌下入路胫骨髓内钉治疗胫骨干骨折的疗效。方法选取2017年1月-2020年1月乌鲁木齐市友谊医院骨科收治的46例胫骨干骨折患者,男性32例,女性14例,年龄23岁-69岁,平均50.1岁。以上病例均实施髓内钉内固定术,按照手术入路分为髌上入路(SPN)与髌下入路(IPN)两组,各23例,比较两组患者的手术时间、出血量、骨折愈合、膝前区疼痛及膝关节功能评分。结果门诊随访12个月-24个月,平均16.5个月。SPN组手术时间(96.45±5.25)分钟少于IPN组(106.73±7.69)分钟。两组相比,SPN组膝前疼痛较轻(VAS评分1.02±1.1 vs 1.58±2.26.),膝关节功能评分较高(Lysholm评分97.13±2.45 vs 92.16±2.66),P<0.05,但两组在出血量(ml)(82.26±5.23 vs 85.12±5.68)、骨折愈合方面(RUST评分28.12±5.46 vs 29.48±6.37),P>0.05,差异无统计学意义。结论两组相比较,应用髌上入路髓内钉治疗胫骨干骨折,操作更简单,术程短,术后膝关节功能评分较高,值得临床推广应用。
Objective To compare the effects of suprapatellar and infrapatellar tibial intramedullary nailing in the treatment of tibial shaft fractures.Methods From January 2017 to January 2020,46 patients with tibial shaft fractures were selected from the Department of Orthopedics of Urumqi Friendship Hospital,32 males and 14 females,aged 23-69 years,with an average age of 50.1 years.The above cases were all treated with intramedullary nailing.According to the surgical approach,they were divided into two groups:suprapatellar approach(SPN)and infrapatellar approach(IPN),23 cases in each group.The operation time,blood loss,fracture healing,anterior knee pain and knee joint function scores of the two groups were compared.Results The outpatient follow-up was 12-24 months,with an average of 16.5months.The operation time in SPN group(96.45±5.25)minutes was less than that in IPN group(106.73±7.69)minutes.Compared with the two groups,SPN group had less anterior knee pain(VAS score 1.02±1.1 vs 1.58±2.26)and higher knee function score(Lysholm score 97.13±2.45 vs 92.16±2.66)(P<0.05),but there was no significant difference between the two groups in terms of blood loss(ml)(82.26±5.23 vs 85.12±5.68)and fracture healing(RUST score 28.12±5.46 vs 29.48±6.37)(P>0.05).Conclusion Compared with the two groups,the use of suprapatellar intramedullary nail in the treatment of tibial shaft fracture is simpler,shorter,and has a higher score of knee joint function,which is worthy of clinical application.
作者
王鑫渊
白合体叶尔·吐尔干
赵国斌
WANG Xin-yuan;BAI He Ti Ye Er·Tu Ee Gan;ZHAO Guo-bin(Department of Orthopaedics,Urumqi Friendship Hospital,830000,Urumqi,China)
出处
《新疆医学》
2022年第9期1039-1042,共4页
Xinjiang Medical Journal
关键词
胫骨干骨折
髌上入路
髌下入路
髓内钉
tibial fractures
suprapatellar approach
infrapatellar approach
intramedullary nailing
作者简介
王鑫渊,男,硕士,副主任医师,研究方向:骨科。
