首页|髌上与髌下入路髓内钉固定术对胫骨干骨折患者术后疼痛及膝关节活动度的影响

髌上与髌下入路髓内钉固定术对胫骨干骨折患者术后疼痛及膝关节活动度的影响

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目的:对比髌上与髌下入路髓内钉固定术对胫骨干骨折患者术后疼痛及膝关节活动度的影响。方法:选取2020 年 12 月—2022 年 12 月贵州医科大学附属白云医院收治的 86 例胫骨干骨折患者作为研究对象,按随机数表法将患者分为对照组与观察组,各 43 例。对照组行髌下入路髓内钉固定术,观察组行髌上入路髓内钉固定术,两组术后均抗感染处理,并持续随访 3 个月。比较两组手术相关指标、疼痛程度、膝关节伸屈活动度、膝关节功能、生活质量及并发症。结果:观察组术中出血量、透视次数少于对照组,手术时间短于对照组,并发症发生率低于对照组,差异有统计学意义(P<0。05);术前,两组视觉模拟评分法(VAS)评分、膝关节伸屈活动度、Lysholm膝关节功能评分与生活质量综合评定问卷(GQOLI-74)各维度评分比较,差异无统计学意义(P>0。05);术后 3 个月,两组VAS评分、膝关节伸屈活动度、Lysholm膝关节功能评分、GQOLI-74 各维度评分较术前改善,且观察组VAS评分低于对照组,膝关节伸屈活动度,Lysholm膝关节功能评分,GQOLI-74 各维度评分高于对照组,差异有统计学意义(P<0。05)。结论:与髌下入路相比,髌上入路髓内钉内固定术在胫骨干骨折患者治疗中效果更显著,可减少术中出血量与透视次数,缩短手术时间,减轻术后疼痛,提高膝关节活动度,加速膝关节功能恢复,改善生活质量,且并发症较少。
Effect of Suprapatellar and Infrapatellar Approach Intramedullary Nail Fixation on Postoperative Pain and Knee Joint Mobility in Patients with Tibial Shaft Fracture
Objective:To compare the effect of suprapatellar and infrapatellar approach intramedullary nail fixation on postoperative pain and knee joint mobility in patients with tibial shaft fracture.Method:A total of 86 patients with tibial shaft fracture who admitted to Baiyun Hospital Affiliated to Guizhou Medical University from December 2020 to December 2022 were selected as the research objects,the patients were divided into the control group and the observation group according to the random number table method,with 43 cases in each group.The control group was treated with infrapatellar approach intramedullary nail fixation,and the observation group was treated with suprapatellar approach intramedullary nail fixation,two groups were treated with anti-infection after operation and were followed up for 3 months.The operation related indexes,pain degree,knee joint flexion and extension activity,knee joint function,quality of life and complications were compared between two groups.Result:The intraoperative blood loss and fluoroscopy times in the observation group were less than those in the control group,the operation time was shorter than that in the control group,and the incidence of complications was lower than that in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in visual analogue scale(VAS)score,knee flexion and extension activity,Lysholm knee function score and the dimensions of generic quality of life inventory-74(GQOLI-74)(P>0.05);at 3 months after surgery,the VAS score,knee flexion and extension range of motion,Lysholm knee function score and GQOLI-74 scores of each dimension in two groups were improved than those before operation,and the VAS score of the observation group was lower than that of the control group,the knee flexion and extension activity,Lysholm knee function score and GQOLI-74 scores of each dimension were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Compared with the infrapatellar approach,the suprapatellar approach intramedullary nail fixation in treating patients with tibial shaft fractures is more effective,it can reduce intraoperative blood loss and fluoroscopy times,shorten operation time,reduce postoperative pain,improve knee joint mobility,accelerate knee joint function recovery,improve quality of life,and have fewer complications.

Tibial shaft fractureIntramedullary nail fixationSuprapatellar approachInfrapatellar approachPainKnee joint mobility

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贵州医科大学附属白云医院 贵州 贵阳 550000

胫骨干骨折 髓内钉固定术 髌上入路 髌下入路 疼痛 膝关节活动度

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(7)
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