摘要
目的 探讨髌上入路胫骨髓内钉内固定术治疗胫骨中下段骨折的效果。方法 选择2021年1月至2023年6月收治的82例胫骨中下段骨折患者,以随机数字表法分为髌上入路组(n=41)和髌下入路组(n=41)。髌上入路组予髌上入路胫骨髓内钉内固定术治疗,髌下入路组予髌下入路胫骨髓内钉内固定术治疗。比较两组术中出血量、手术与骨折愈合时间、术后并发症与康复效果;观察术后3、5、8周患者视觉模拟疼痛评分法(VAS)评分,术后3、6个月美国特种外科医院膝关节评分(HSS)情况。结果 较髌下入路组,髌上入路组术中出血量更少,手术与骨折愈合时间更短(P<0.05);两组术后并发症发生率及康复优良率比较差异无统计学意义(P>0.05);术后3、5、8周,髌上入路组VAS评分较髌下入路组低(P<0.01);术后3、6个月,髌上入路组HSS评分比髌下入路组高(P<0.01)。结论 胫骨中下段骨折后需积极手术治疗,髌上入路胫骨髓内钉内固定较髌下入路胫骨髓内钉内固定手术时间短,出血少,损伤小,骨折愈合快,术后疼痛较轻,可促进患者肢体功能恢复。
Objective To explore the effect of intramedullary nail internal fixation of the tibia via the suprapatellar approach in the treatment of middle and lower tibial fractures.Methods A total of 82 patients with middle and lower tibial fractures admitted to from January 2021 to June 2023 were selected and divided into the suprapatellar approach group(n=41)and the infrapatellar approach group(n=41)by random number table method.The suprapatellar approach group was treated with intramedullary nail internal fixation of the tibia via suprapatellar approach,and the infrapatellar approach group was treated with intramedullary nail internal fixation of the tibia via infrapatellar approach.Intraoperative blood loss,duration of surgical and fracture healing,postoperative complications and rehabilitation effects were compared,and Visual Analogue Scale(VAS)scores of patients at 3 weeks,5 weeks,and 8 weeks after surgery,and Hospital for Special Surgery Knee Score(HSS)of the United States at 3 and 6 months after surgery were observed.Results Compared with the infrapatellar approach group,the suprapatellar approach group had less intraoperative blood loss and shorter duration of operation and fracture healing(P<0.05).There was no significant difference in the incidence of postoperative complications and the excellent and good rate of rehabilitation between the two groups(P>0.05).At 3,5 and 8 weeks after the operation,the VAS scores of patients in the suprapatellar approach group were lower than those in the infrapatellar approach group(P<0.01).At 3 and 6 months after the operation,the HSS score in the suprapatellar approach group was higher than that in the infrapatellar approach group(P<0.01).Conclusion For the middle and lower tibial fracture,active surgical treatment is required.Compared with intramedullary nail internal fixation of the tibia via infrapatellar approach,intramedullary nail internal fixation of the tibia via suprapatellar approach has a shorter duration of operation,less blood loss,less injury,faster fracture healing and less postoperative pain,which can promote the recovery of limb function.
作者
高玉盛
臧业峰
姚大伟
霍明昌
杨尚晟
董智勇
GAO Yusheng;ZANG Yefeng;YAO Dawei;HUO Mingchang;YANG Shangsheng;DONG Zhiyong(Department of Spinal Trauma Surgery,Qingdao Jiaozhou Central Hospital,Qingdao,Shandong 266300,China;Department of Joint Trauma Surgery,Qingdao Jiaozhou Central Hospital,Qingdao,Shandong 266300,China)
出处
《临床误诊误治》
2025年第15期63-66,共4页
Clinical Misdiagnosis & Mistherapy
基金
山东省医药卫生科技项目(202104070268)。
关键词
胫骨中下段骨折
髌上入路胫骨髓内钉内固定
并发症
疼痛
康复效果
美国特种外科医院膝关节评分
middle and lower tibial fractures
intramedullary nail internal fixation of the tibia via suprapatellar approach
complications
pain
rehabilitation effect
Hospital for Special Surgery Knee Score
作者简介
高玉盛,硕士研究生,主治医师。主要从事脊柱退变性疾病及创伤方向研究;通信作者:董智勇,Email:18153267110@163.com。
