经髌上入路髓内钉固定治疗胫骨骨折的效果

Treatment Effect of Tibial Fracture with Intramedullary Nail via Suprapatellar Approach

目的:研究经髌上入路髓内钉固定治疗胫骨骨折的效果.方法:选择2016年12月-2019年6月在笔者所在医院进行治疗的胫骨骨折患者52例,使用随机数字表法将患者分为上入路组和下入路组,各26例.上入路组经髌上入路髓内钉固定治疗,下入路组经髌下入路髓内钉固定治疗.对比两组患者的膝关节活动情况、膝关节评分、骨折愈合时间、不良反应情况.结果:上入路组的膝关节屈曲和伸展度数均优于下入路组(P<0.05);上入路组的膝关节Lysholm评分、HSS评分高于下入路组(P<0.05),骨折愈合时间短于下入路组(P>0.05);上入路组的不良反应发生率(7.69%)低于下入路组的不良反应发生率(38.46%),差异有统计学意义(P<0.05).结论:经髌上入路髓内钉固治疗胫骨骨折患者的效果显著,骨折愈合时间短,术后膝关节活动度较好,并且不良反应发生率较低.

Objective:To study the effect of suprapatellar intramedullary nailing in the treatment of tibial fracture.Method:A total of 52 cases of tibial fracture treated in our hospital from December 2016 to June 2019 were selected.The patients were divided into upper approach group and lower approach group,with 26 cases in each.The upper approach group was treated with intramedullary nailing via suprapatellar approach,and the lower approach group was treated with intramedullary nailing via infrapatellar approach.The knee joint activity,knee joint score,fracture healing time and adverse reactions were compared between the two groups.Result:The clinical efficacy of the upper approach group(96.15%)was higher than 76.92%of the lower approach group(P<0.05).The Lysholm and HSS scores of the upper approach group were higher than those of the lower approach group(P<0.05).The incidence of adverse reactions in the upper approach group(7.69%)was lower than 38.46%in the lower approach group(P<0.05).Conclusion:The treatment of tibial fracture by intramedullary nailing via suprapatellar approach has a significant effect,with a short time of fracture healing,a good degree of knee joint activity and a low incidence of adverse reactions.