Clinical Study of Internal Fixation with Intramedullary Nail via Parapatellar Approach in the Treatment of Tibial Fracture
Objective:To explore the clinical effect of internal fixation with intramedullary nail via parapatellar approach in the treatment of tibial fracture.Method:A total of 78 patients with tibial fracture admitted to the First People's Hospital of Fuzhou from April 2022 to April 2023 were selected for a prospective study,and were divided into study group(n=39)and control group(n=39)according to random number table method.The control group was treated with internal fixation with intramedullary nail via infrapatellar approach,and the study group was treated with internal fixation with intramedullary nail via parapatellar approach.The clinical efficacy,incidence of poor reduction,clinical indexes,pain degree[visual analogue scale(VAS)],knee function[American hospital for special surgery knee score(HSS)]and complication rate were compared between the two groups.Result:Compared with the control group,the clinical efficacy and excellent and good rate of the study group were better,the differences were statistically significant(P<0.05).There was no significant difference in the poor reduction rate between two groups(P>0.05).Compared with the control group,the operation time,fracture healing time and hospital stay of the study group were shorter,the intraoperative bleeding volume was less,and the postoperative secondary displacement rate was lower,the differences were statistically significant(P<0.05).There were significant differences in time point effect,inter-group effect and interaction effect of VAS scores between the two groups(Ftime point=1,508.891,Finter-group=18.349,Finteraction=7.257,P<0.05).Compared with admission,VAS scores of both groups were lower at discharge and 3 months after surgery,and those in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).There were significant differences in time point effect,inter-group effect and interaction effect of HSS between the two groups(Ftime point=1,139.491,Finter-group=10.657,Finteraction=23.180,P<0.05).Compared with discharge,HSS in both groups were increased 3 and 6 months after surgery,and those in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).Compared with the control group,the complication rate of the study group was lower(38.46% vs 15.38% ),the difference was statistically significant(P<0.05).Conclusion:Internal fixation with intramedullary nail via parapatellar approach has a good clinical effect in the treatment of tibial fracture,which can effectively relieve pain,improve knee joint function,reduce the incidence of complications and promote patient recovery.
Tibial fractureInternal fixation with intramedullary nailParapatellar approachInfrapatellar approach
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