髌上/髌下入路髓内钉治疗胫骨骨折的效果观察

Effect Observation of Intramedullary Nailing with Suprapatellar/Subpatellar Approach on Tibial Fracture

目的:探讨髌上/髌下入路髓内钉治疗胫骨骨折的应用效果.方法:回顾性分析2019年8月—2022年10月于我院行髓内钉治疗的87例胫骨骨折患者.排除其他影响因素后,共51例病例纳入本研究.其中髌上入路28例,髌下入路23例.比较2组患者术中透视总时间、透视次数及放射暴露剂量.结果:51例患者均顺利完成手术,骨折均获得满意复位,无深部感染及严重并发症发生.与髌下入路比较,髌上入路胫骨髓内钉术中透视总时间、透视次数、放射暴露剂量更少,组间差异有统计学意义(P<0.05).结论:在同时熟练掌握髌上和髌下髓内钉技术的外科医生中,髌上入路术中C型臂X线机透视时间及放射暴露量明显减少,可降低手术医师及患者的放射暴露.

Objective:To investigate the effect of intramedullary nailing with suprapatellar/subpatellar approach on tibial fracture.Methods:A retrospective analysis was performed on 87 patients with tibial fracture who received intramedullary nailment in our hospital from August 2019 to October 2022.After excluding other factors,51 cases were included in this study.There were 28 cases of suprapatellar approach and 23 cases of suprapatellar approach.The total intraoperative fluoroscopy time,fluoroscopy times and radiation exposure dose were compared between the two groups.Results:All the 51 patients successfully completed the operation,all the fractures were satisfactorily reduced,and no deep infection or serious complications occurred.Compared with the suprapatellar approach,the total fluoroscopy time,fluoroscopy times and radiation exposure dose of the suprapatellar approach were less,and the differences between groups were statistically significant(P<0.05).Conclusion:Among surgeons who were proficient in both suprapatellar and subpatellar napping techniques,the C-arm fluoroscopy time and radiation exposure during suprapatellar approach were significantly reduced,which could reduce the radiation exposure of surgeons and patients.