临床骨科杂志2025，Vol.28Issue(1)：117-121,5.DOI:10.3969/j.issn.1008-0287.2025.01.037
两种入路髓内钉固定治疗胫骨干下段1/3骨折的疗效比较
Comparison of efficacy of intramedullary nails with two kinds of approaches on distal one third tibial shaft fractures
摘要
Abstract
Objective To compare the efficacy of suprapatellar nailing(SPN)and infrapatellar nailing(IPN)on distal one third tibial shaft fractures.Methods A total of 67 patients who were treated with intramedullary nailing for distal one third tibial shaft fractures were divided into two groups based on the surgical approach:the SPN group(treated with SPN fixation,33 cases)and the IPN group(treated with IPN fixation,34 cases).The surgical conditions,fracture reduction and healing status,joint function recovery,and incidence of complications were compared between the two groups.Results All patients were followed up for 12～24 months.The SPN group showed superiority over the IPN group in terms of surgical time,intraoperative fluoroscopy times,and the incidence of intraoperative reduction difficulty(P<0.05).There was no statistical difference in the rate of closed reduction between the two groups(P>0.05).Postoperatively,the coronal plane angulation at the fracture site was smaller in the SPN group than the IPN group(P<0.05),while there was no statistical difference in the sagittal plane angulation between the two groups(P>0.05).There was also no statistical difference in the fracture healing time between the two groups(P>0.05).At the final follow-up,the range of knee flexion in the SPN group was greater than that in the IPN group,and the SPN group was higher than the IPN group in the excellent-good rate of lower limb functional score assessed with the Johner-Wruhs cri-terion(P<0.05).The incidence of malalignment and knee pain were lower in the SPN group than those in the IPN group(P<0.05),while there were no statistical differences in the incidence of nonunion between the two groups(P>0.05).Conclusions Compared with IPN,SPN for distal one third tibial shaft fractures is simpler and more effective in the reduction process,which has a lower incidence of postoperative knee pain and malalignment and other complica-tions,and better fracture reduction and limb function recovery.关键词
胫骨干下段1/3骨折/髌上入路/髌下入路/髓内钉Key words
distal one third tibial shaft fractures/suprapatellar approach/infrapatellar approach/intramedullary nail分类
医药卫生引用本文复制引用
尹进,陈明,王加飞,朱大伟,王冰,杨光辉..两种入路髓内钉固定治疗胫骨干下段1/3骨折的疗效比较[J].临床骨科杂志,2025,28(1):117-121,5.基金项目
江苏省宿迁市科技局指导性科技计划(编号:Z2022045) （编号:Z2022045）
江苏省科技厅重点研发计划(编号:BE2019703) （编号:BE2019703）
