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髌上入路胫骨髓内钉治疗胫骨近端骨折
Hits: 2199   Download times: 1325   Received:April 11, 2015    
作者Author单位UnitE-Mail
解冰 XIE Bing 沈阳军区总医院骨科, 辽宁 沈阳 110016 epartment of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
杨超 YANG Chao 沈阳军区总医院骨科, 辽宁 沈阳 110016 epartment of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
田竞 TIAN Jing 沈阳军区总医院骨科, 辽宁 沈阳 110016 epartment of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China bone@medmail.com.cn 
周大鹏 ZHOU Da-peng 沈阳军区总医院骨科, 辽宁 沈阳 110016 epartment of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
期刊信息:《中国骨伤》2015年28卷,第10期,第955-959页
DOI:10.3969/j.issn.1003-0034.2015.10.017


目的:探讨膝关节半伸直位髌上入路胫骨髓内钉治疗胫骨近端骨折的临床疗效。

方法:2013年1月至2014年1月共收治胫骨近端骨折16例,男14例,女2例;年龄26~57岁,平均42.2岁。所有患者为单侧闭合骨折,采用膝关节半伸直位髌上入路META-NAIL胫骨髓内钉内固定治疗。记录手术时间、术后并发症、骨愈合时间、胫骨力线和膝关节活动范围,并采用视觉模拟评分法(visual analogue scale,VAS)和Lysholm膝关节评分评定手术疗效。

结果:所有16例患者手术时间65~95 min,平均(75.7±8.3) min.无明显围手术期并发症发生。所有患者获随访,时间12~24个月,平均(15.6±8.1)个月。15例获得Ⅰ期骨愈合,平均骨愈合时间(3.6±1.8)个月(3~5个月).末次随访时,所有患者胫骨力线良好,无膝前疼痛。患侧膝关节屈伸活动范围平均(124.4±18.8)°,健侧(127.5±16.7)°。Lysholm膝关节评分77~92分,平均86.4±12.3.

结论:膝关节半伸直位髌上入路胫骨髓内钉治疗胫骨近端骨折,术中复位及固定操作方便,术后并发症少,患肢功能恢复良好,临床疗效满意。
[关键词]:胫骨  骨折  骨折固定术,内
 
Tibial intramedullary nailing using a suprapatellar approach for the treatment of proximal tibial fractures
Abstract:

Objective:To study the clinical efficacy of semiextended intramedullary nailing of the tibia using a suprapatellar approach for proximal tibial fractures.

Methods:From January 2013 to January 2014,a total of 16 patients with unilateral proximal tibial fractures,14 males and 2 females,underwent closed reduction and internal fixation with TRIGENTM META-NAILTM via the suprapatellar approach. The average age was 42.2 years old(ranged,26 to 57 years old). Radiographic and clinical follow-up examinations were performed at a minimum of 1 year after surgery. Measurements included surgery time,complications,bone healing time,tibial alignment,knee range of motion,pain scoring (visual analogue scale) and functional outcome (Lysholm knee score).

Results:The average surgery time was (75.7±8.3) minutes (ranged,65 to 95 minutes). No obvious complications were recorded. Average duration of follow-up was (15.6±8.1) months (ranged,12 to 24 months). Fifteen patients attained radiological bone union for a mean time of (3.6±1.8) months (ranged,3 to 5 months). At the final follow-up,all tibial alignments were good,and no patients complained of anterior knee pain. Mean arc of knee motion was (124.4±18.8) degrees for the affected extremity compared with(127.5±16.7) degrees for the contra-lateral knee. The total scores of Lysholm knee score ranged from 77 to 92,average 86.4±12.3.

Conclusion:For proximal tibial fractures,the semiextended intramedullary nailing technique via a suprapatellar approach can obtain satisfactory clinical outcomes with simplicity in reduction and fixation,minimal complications,and good recovery of limbs function.
KEYWORDS:Tibia  Fractures  Fracture fixation, internal
 
引用本文,请按以下格式著录参考文献:
中文格式:解冰,杨超,田竞,周大鹏.髌上入路胫骨髓内钉治疗胫骨近端骨折[J].中国骨伤,2015,28(10):955~959
英文格式:XIE Bing,YANG Chao,TIAN Jing,ZHOU Da-peng.Tibial intramedullary nailing using a suprapatellar approach for the treatment of proximal tibial fractures[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(10):955~959
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