| 半伸直位髌上入路髓内钉治疗胫骨骨折 |
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投稿时间：2020-09-21
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| 作者 | Author | 单位 | Address | E-Mail |
| 杨育生 |
YANG Yu-sheng |
杭州市萧山区第一人民骨二科, 浙江 杭州 311201 |
The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China |
xsyang2005@sohu.com |
| 叶家宽 |
YE Jia-kuan |
杭州市萧山区第一人民骨二科, 浙江 杭州 311201 |
The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China |
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| 方勇 |
FANG Yong |
杭州市萧山区第一人民骨二科, 浙江 杭州 311201 |
The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第5期，第452-457页 |
| DOI：10.12200/j.issn.1003-0034.2021.05.011 |
| 基金项目: |
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中文摘要:
目的： 探讨膝关节半伸直位髌上入路胫骨髓内钉治疗胫骨骨折的临床疗效。
方法： 回顾性分析2018年1月至2019年6月采用髌上入路胫骨髓内钉治疗的胫骨骨折患者23例，男18例，女5例；年龄26~67（38.5±9.6）岁。其中胫骨近端骨折8例，胫骨中段骨折7例，胫骨远端骨折6例，胫骨多段骨折2例。记录患者的手术时间、术中出血量、术后并发症、骨愈合时间，比较术后3 d与术后3个月膝关节活动范围及膝关节疼痛视觉模拟评分（visual analogue scale，VAS），术后6个月采用膝关节美国特种外科医院（Hospital for Special Surgery，HSS）评分进行临床疗效评价。
结果： 所有患者获得随访，时间8~19（12.3±7.6）个月。手术时间50~85（55.3±5.1） min，出血量50~150（84.0±8.7） ml。无明显围手术期并发症发生。所有骨折获得Ⅰ期骨愈合，骨愈合时间3~8（4.6±1.5）个月。膝关节屈伸活动范围由术后3 d的（110.4±15.3）°提高至术后3个月的（123.7±16.5）°，差异有统计学意义（t=6.57，P<0.001）；术后3 d膝关节VAS评分（0.22±0.74）分与术后3个月（0.04±0.20）分比较差异无统计学意义（t=1.09，P>0.05）。术后6个月膝关节HSS评分为（86.2±11.5）分，其中优19例，良4例。
结论： 膝关节半伸直位髌上入路胫骨髓内钉治疗胫骨骨折，操作简便，对软组织损伤小，膝关节疼痛率低，术后患肢功能恢复快，并发症少，对于胫骨多段骨折及合并同侧下肢多发骨折的患者尤其适用，是一种简便、安全有效的手术方法。 |
| 【关键词】胫骨骨折 骨折固定术,内 体位 |
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| Intramedullary nailing through suprapatellar approach with semiextended position for the treatment of tibial fractures |
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ABSTRACT
Objective: To explore clinical effects of intramedullary nailing through suprapatellar approach with semiextended position in treating tibial fractures.
Methods: From January 2018 to June 2019, 23 patients with tibia fractures were treated with suprapatellar approach intramedullary nailing on knee semiextended position, including 18 males and 5 females, aged from 26 to 67 years old with an average age of(38.5±9.6) years old. Eight patients were tibial proximal fractures, 7 patients were tibial shaft fractures, 6 patients were tibial distal fractures and 2 patients were tibial segmental fractures. Operation time, intraoperative blood loss, complications and fracture healing time were recorded. Range of motivation of knee joint between 3 days and 3 months after operation were compared, Hospital for Special Surgery(HSS) score and visual analogue scale(VAS) were used to evaluate clinical effects.
Results: All patients were followed up from 8 to 19 months with an average of (12.3±7.6) months. Operation time was (55.3±5.1) min, intraoperative blood loss was (84.0±8.7) ml. No obvious complications occurred. All patients were achieved bony union at stageⅠ, fracture healing time ranged from 3 to 8 months with an average of (4.6±1.5) months. Flexion extension range of knee motion at 3 days after operation was (110.4±15.3)°, and increased to (123.7±16.5)° at 3 months after operation (t=6.57, P<0.001). Postoperative VAS at 3 days was(0.22±0.74) scores, and decreased to(0.04±0.20) scores at 3 months after operation(t=1.09, P>0.05). Postoperative HSS score at 6 months was 86.2±11.5, and 19 got excellent result and 4 good.
Conclusion: Intramedullary nailing through suprapatellar approach with semiextended position in treating tibia fractures has advantages of simple operation, less trauma for soft tissue, less pain, rapid recovery of function and less complication. It is especially suitable for patients with tibial multi-segment fracture and multiple fractures of ipsilateral lower limb for safety and simple. |
| KEY WORDS Tibia fractures Fracture fixation,internal Posture |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 杨育生,叶家宽,方勇.半伸直位髌上入路髓内钉治疗胫骨骨折[J].中国骨伤,2021,34(5):452~457 |
| 英文格式: | YANG Yu-sheng,YE Jia-kuan,FANG Yong.Intramedullary nailing through suprapatellar approach with semiextended position for the treatment of tibial fractures[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(5):452~457 |
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