磁力导航META-NAIL锁定型胫骨髓内钉髌上入路治疗胫骨干骨折的优势

Magnetic navigation META-NAIL interlocking intramedullary nailing for tibial shaft fractures via the supra-patellar approach

背景:磁力导航META髓内钉结合髌上入路是治疗胫骨干骨折的一种新颖手术方式,较传统手术方式有明显的优势。目的:回顾性分析磁导航META髓内钉结合髌上入路治疗胫骨干骨折的特点。方法:收集58例胫骨干骨折患者的病历资料进行回顾性分析,患者均为单侧闭合骨折,均应用磁力导航META-NAIL锁定型胫骨髓内钉髌上入路内固定治疗。术后预防性使用抗生素,术后3d开始进行无负重功能锻炼,平均12周后进行完全负重功能锻炼。结果与结论:①内固定后24周Lysholm评分为83-95分,平均90分;②Johner-Wruh标准评价临床优良率约为95%;③手术时间平均为65 min,出血量平均为30 mL;④内固定后随访中无患者出现患肢膝关节疼痛;(5)所有患者未出现伤口不愈合、感染、骨不连、骨髓炎、畸形愈合等并发症;(6)回顾性分析结果表明,应用磁力导航META-NAIL锁定型胫骨髓内钉髌上入路内固定治疗胫骨干骨折,手术时间短、复位满意、固定可靠;可避免切开髌腱等组织,减少膝前疼痛率;术后能够早期功能锻炼,临床效果满意。

BACKGROUND： Magnetic navigation META nailing for tibial fractures via the supra-patellar approach is a novel surgical method, exhibiting overt advantages.OBJECTIVE： To retrospectively analyze the clinical characters of magnetic navigation META nailing via the supra-patellar approach for tibial fractures.METHODS： Clinical data of 58 cases of tibial shaft fracture were collected and analyzed retrospectively, and all patients were treated with navigation META-NAIL via the supra-patellar approach. The patients received the postoperative prophylactic antibacterial therapy; non-weight bearing functional training was performed at 3 days postoperatively, and full weight-bearing functional exercise was conducted at an average of 12 weeks postoperatively.RESULTS AND CONCLUSION： （1） The Lysholm scores ranged from 83 to 95 （average, 90） at 24 weeks postoperatively. （2） The excellent and good rate evaluated by Johner-Wruh scoring reached up to 95％. （3） The average operation time was 65 minutes, and the blood loss was 30 mL. （4） There was no complaint of knee pain during the follow-up. （5） No postoperative complications, such as non-healing wounds, infection, bone nonunion, osteomyelitis or deformity recovery, occurred.（6） These results manifest that the magnetic navigation META-NAIL for tibial shaft fractures via the supra-patellar approach exerts a lot of advantages, including short operation time, accurate reduction and stable fixation. Most importantly, it can avoid cut patellar tendon tissue, and reduce the rate of knee pain, further promoting early functional exercise, which obtains satisfactory treatment outcomes.