髌上入路髓内钉内固定对胫骨近端骨折患者术后骨折愈合时间及HSS评分的影响

The Effect of Suprapatellar Approach Intramedullary Nail Internal Fixation on the Postoperative Fracture Healing Time and HSS Score of Patients with Proximal Tibial Fractures

目的探究髌上入路髓内钉内固定对胫骨近端骨折患者术后骨折愈合时间及(HSS)评分的影响。方法选取我院60例胫骨近端骨折患者(2016年8月至2019年8月)作为研究对象,按照随机数字表法分为观察组30例和对照组30例,对照组采用髌下入路髓内钉内固定术治疗,观察组采用髌上入路髓内钉内固定术治疗。比较两组围术期指标及骨折愈合时间、术前、术后3、6、12日视觉模拟评分法(VAS)评分及术前、术后3、6、12个月HSS评分。结果观察组住院时间、累计透视时间、手术时间、骨折愈合时间短于对照组,透视次数少于对照组(P<0.05),术中出血量与对照组比较无明显差异(P>0.05);术后3、6、12日观察组VAS评分低于对照组(P<0.05);术后12个月观察组HSS评分高于对照组(P<0.05)。结论髌上入路髓内钉内固定应用于胫骨近端骨折患者中可有效促使膝关节功能恢复,减轻膝前疼痛,缩短手术、住院及骨折愈合时间,减少透视次数,促进术后恢复。

Objective To explore the effect of suprapatellar approach intramedullary nail internal fixation on the postoperative fracture healing time and(HSS)score of patients with proximal tibial fractures.Methods Sixty patients with proximal tibial fractures in our hospital(August 2016 to August 2019)were selected as the research objects.According to the random number table method,they were divided into observation group(n=30)and control group(n=30).The group was treated with subpatellar approach intramedullary nail fixation,and the observation group was treated with suprapatella approach intramedullary nail fixation.Compare the two groups of perioperative indicators and fracture healing time,preoperative and postoperative 3 d,6 d,12 d visual analogue scale(VAS)scores and preoperative,3 months,6 months,and 12 months after surgery HSS score.Results The hospitalization time,cumulative fluoroscopy time,operation time,and fracture healing time of the observation group were shorter than those of the control group,and the number of fluoroscopy was less than that of the c ontrol group(P<0.05).There was no significant difference in intraoperative blood loss compared with the control group(P>0.05);The VAS score of the observation group was lower than that of the control group at 3,6,and 12 days after operation(P<0.05);the HSS score of the observation group was higher than that of the control group at 12 months after operation(P<0.05).Conclusion The application of suprapatella intramedullary nail fixation in patients with proximal tibial fractures can effectively promote the recovery of knee joint function,reduce anterior knee pain,shorten surgery,hospitalization and fracture healing time,reduce the number of fluoroscopy,and promote postoperative recovery.