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髌上入路与经髌韧带入路交锁髓内钉治疗胫骨骨折的疗效分析 被引量:11

Clinical effect of interlocking intramedullary nailing via suprapatellar versus transpatellar tendon approach in the treatment of tibial fracturee
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摘要 目的探讨髌上入路与经髌韧带入路交锁髓内钉内固定治疗胫骨骨折的有效性及安全性。方法选择2015年1月至2017年1月收治的80例胫骨干骨折患者作为研究对象,根据随机数字法分为观察组(n=40)和对照组(n=40)。观察组接受髌上入路髓内钉内固定治疗,对照组接受经髌韧带入路髓内钉内固定治疗。记录并比较两组患者的手术时间、出血量、骨折愈合时间、术后不同时间膝关节HSS评分及优良率、术后膝关节疼痛等并发症情况。结果观察组手术时间、术中失血量均少于对照组,差异不具有统计学意义(t=-1.764,t=-1.723,P>0.05);观察组骨折愈合时间短于对照组,差异具有统计学意义(t=-3.632,P<0.05);两组患者术后2周膝关节HSS评分差异比较无统计学意义(t=0.585,P>0.05);观察组术后6个月及12个月膝关节HSS评分均优于对照组,差异具有统计学意义(t=3.221,t=3.288,P<0.05);观察组末次随访时膝关节HSS评分优良率显著优于对照组,差异具有统计学意义(χ~2=4.507,P<0.05);两组患者术后均无严重并发症发生。结论髌上入路置入髓内钉治疗胫骨骨折能够获得显著临床效果,有利于膝关节功能恢复,促进患者快速康复,推荐临床应用。 Objective To investigate the effectiveness and safety of interlocking intramedullary nailing via suprapatellar versus transpatellar tendon approach in the treatment of tibial fracture.Methods From Jan.2015to Jan.2017,80cases of tibial fractures were included in the study,according to the random number method,they were divided into observation group(n=40)and control group(n=40).The observation group was treated with intramedullary nailing via suprapatellar,while the control group was treated with intramedullary nailing via transpatellar tendon approach.The operation time,intraoperative bleeding volume,fracture healing time,postoperative HSS score at different time points,incidence of postoperative complications of the two groups were recorded and compared.Results The operation time and intraoperative bleeding volume in the observation group were lower than those in the control group,the difference was not statistically significant(t=-1.764,t=-1.723,P>0.05).Fracture healing time was lower than that in the control group,the difference was statistically significant(t=-3.632,P<0.05).At2weeks after treatment,the HSS score in the observation group was higher than that in the control group,the difference was not statistically significant(t=0.585,P>0.05).At6,12months after treatment,the HSS score in the observation group was higher than that in the control group,the difference were statistically significant(t=3.221,t=3.288,P<0.05).At the final follow-up,the HSS score excellent rate of the observation group was higher than that of the control group,the difference was statistically significant(χ^2=4.507,P<0.05).There were no serious complications in the two groups after treatment.Conclusion Intramedullary nailing via suprapatellar approach can achieve good treatment effect in the treatment of tibial shaft fractur,it can improve the knee joint function,fast recovered.
作者 杨红航 孙振国 翁伟 闵继康 李恒 YANG Honghang;SUN Zhenguo;WENG Wei(The First People's Hospital of Huzhou, Zhejiang 313000, China)
出处 《浙江创伤外科》 2018年第6期1073-1076,共4页 Zhejiang Journal of Traumatic Surgery
基金 浙江省自然科学基金资助项目(LY14H060001) 浙江省湖州市科技计划一般项目(2016GY26) 浙江省科技计划公益技术应用研究项目(2017C33227)
关键词 髌上入路 经髌韧带入路 胫骨骨折 交锁髓内钉 Suprapatellar approach Transpatellar tendon approach Tibial fracture Interlocking intramedullary nailing
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