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髌上入路与髌下入路胫骨髓内钉治疗胫骨远端骨折的比较
Comparison of suprapatellar and infrapatellar approach intramedullary nail techniques in treating distal tibial fractures
投稿时间:2023-07-24  
DOI:10.3969/j.issn.1672-5972.2024.02.011
中文关键词:  胫骨远端骨折  髓内钉  髌上入路  髌下入路
英文关键词:Distal tibial fracture  Intramedullary nail  Suprapatellar approach  Infrapatellar approach
基金项目:上海市浦东新区临床特色学科(PWYts2021-3)
作者单位邮编
高峰 上海市浦东新区周浦医院(上海健康医学院附属周浦医院)骨科上海201318 201318
王秀会 上海市浦东新区周浦医院(上海健康医学院附属周浦医院)骨科上海201318 201318
夏胜利 上海市浦东新区周浦医院(上海健康医学院附属周浦医院)骨科上海201318 201318
周小小 上海市浦东新区周浦医院(上海健康医学院附属周浦医院)骨科上海201318 201318
郭胜洋 上海市浦东新区周浦医院(上海健康医学院附属周浦医院)骨科上海201318 201318
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中文摘要:
      目的 研究髌上入路与髌下入路胫骨髓内钉治疗胫骨远端骨折的疗效。方法 回顾性分析2020年1月至2021年12月上海市浦东新区周浦医院治疗且获随访的85例胫骨远端骨折的患者资料。其中,48例采用髌上入路胫骨髓内钉固定(髌上组),37例采用髌下入路胫骨髓内钉固定(髌下组)。比较两组患者的术后胫骨远端矢状面、冠状面骨折复位和踝关节AOFAS评分。结果 所有患者均获得随访,平均随访时间为(13.5±5.6)个月。髌上组的骨折矢状面成角(4.1°±0.89°)小于髌下组(5.6°±1.25°),差异有统计学意义(P<0.05)。髌上组冠状面成角(4.2°±0.82°)小于髌下组(5.8°±1.32°),差异有统计学意义(P<0.05)。髌上组骨折复位不良2例(4.17%),髌下组10例(27.02%),差异有统计学意义(P<0.05)。髌上组AOFAS评分[(97.3±4.50)分]高于髌下组[(92.0±5.72)分],踝关节疼痛评分髌上组[(37.3±4.50)分]高于髌下组[(32.0±5.72)分],差异有统计学意义(P<0.05)。结论 与髌下入路相比,髌上入路髓内钉治疗胫骨远端骨折,骨折复位更简单,能获得更好的术后骨折对位和更好的踝关节功能
英文摘要:
      Objective To compare the fracture alignment and ankle functional outcomes with intramedullary nails using suprapatellar and infrapatellar approaches in treating distal tibial fractures.Methods From January 2020 to December 2021, 85 patients with distal tibial fractures in Shanghai Pudong New District Zhoupu Hospital were analyzed. The suprapatellar approach group included 48 patients who were treated with intramedullary nails using suprapatellar approaches, the infrapatellar approach group included 37 patients who were fixed with intramedullary nails only undergoing traditional infrapatellar approaches. The fracture sagittal and coronal alignment and ankle AOFAS outcomes were emphatically compared.Results All the patients were followed up for an average duration of (13.5±5.6) months. The average sagittal section angle of the fracture in the suprapatellar and infrapatellar approach groups were (4.1°±0.89°) and (5.6°±1.25°), respectively (P<0.05). The average coronal section angle were (4.2°±0.82°) and (5.8°±1.32°), respectively (P<0.05). Two patients (4.17%) in the suprapatellar approach group and 10 patients (27.02%) in the infrapatellar approach group had poor fracture reduction (P<0.05). The average AOFAS were (97.3±4.50) points and (92.0±5.72) points in the suprapatellar and infrapatellar approach groups respectively (P<0.05). The average ankle pain scores were (37.3±4.50) points and (32.0±5.72) points, respectively (P<0.05).Conclusion Compared with infrapatellar approach, the suprapatellar approach can achieve easier fracture reduction, better postoperative fracture alignment, and better ankle function.
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