中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (43): 8079-8082.doi: 10.3969/j.issn.1673-8225.2011.43.025

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

髓内针置入内固定胫骨骨折后膝关节功能比较及组织学评价

朱龙章，薛  锋，韩本松   

  1. 上海市奉贤区中心医院骨科，上海市  201400
  • 收稿日期:2011-06-30 修回日期:2011-08-16 出版日期:2011-10-22 发布日期:2011-10-22
  • 通讯作者: 韩本松，硕士，主治医师，上海市奉贤区中心医院骨科，上海市 201400 hanbensong@126.com 并列通讯作者：薛锋，博士，主任医师，上海市奉贤区中心医院骨科，上海市 201400 xuemd@yahoo.com.cn
  • 作者简介:朱龙章，男，1964年生，上海市人，汉族，1988年上海第二医科大学毕业，副主任医师，主要从事骨折创伤方面的研究。 lz_zhu@126.com

Knee function comparison and histological evaluation of the tibial shaft after intramedullary nail fixation

Zhu Long-zhang, Xue Feng, Han Ben-song   

  1. Department of Orthopedics, Central Hospital of Fengxian District, Shanghai  201400, China
  • Received:2011-06-30 Revised:2011-08-16 Online:2011-10-22 Published:2011-10-22
  • Contact: Han Ben-song, Master, Attending physician, Department of Orthopedics, Central Hospital of Fengxian District, Shanghai 201400, China hanbensong@ 126.com Correspondence to: Xue Feng, Doctor, Chief physician, Department of Orthopedics, Central Hospital of Fengxian District, Shanghai 201400, China xuemd@yahoo.com.cn
  • About author:Zhu Long-zhang, Associate chief physician, Department of Orthopedics, Central Hospital of Fengxian District, Shanghai 201400, China lz_zhu@126.com

PDF

325

被引次数

15

摘要：

背景：髓内钉内固定后膝关节组织生物学改变也是影响膝关节功能的重要因素。
目的：分析比较胫骨骨折经不同入路髓内针固定后膝关节功能，并对入口周围髌韧带和脂肪垫损伤进行组织学比较评价。
方法：纳入分析45例闭合性胫骨干骨折经髓内针治疗的患者资料，按照不同的置入途径分为3组：经髌韧带途径组、经髌韧带内侧旁组和髌韧带外侧旁组。
结果与结论：置入后膝关节功能评分各组间比较，差异无显著性意义(P > 0.05)。经髌韧带途径组置入过程中髌韧带和脂肪垫明显挫裂伤发生率高于其他两组(P < 0.05)；置入后入路切口内瘢痕增生程度、膝关节功能障碍及疼痛程度经髌韧带组较髌韧带内侧旁组和外侧旁组要明显。说明和经髌韧带途径相比，髌韧带内侧旁和髌韧带外侧旁途径有着更好的膝关节功能和更轻的髌韧带和脂肪垫损伤。

关键词: 胫骨骨折, 髓内针, 内固定, 膝关节功能, 组织学

Abstract:

BACKGROUND: Biological changes of the knee after intramedullary nail fixation is an important factor influencing knee function.
OBJECTIVE: To analyze and compare the knee function following tibial fractures treated with intramedullary nail fixation by different approaches, and to make histological comparisons and evaluation for patellar tendon and fat pad damage.
METHODS: In a retrospective case study, we evaluated 45 patients with history of closed tibial shaft fracture who had been treated by intramedullary nail fixation. The 45 patients were divided into transpatellar, medial parapatellar and lateral parapatellar groups.
RESULTS AND CONCLUSION: There was no difference in the scores of knee function among the three groups after implantation (P > 0.05). Scar formation degree in the surgical incision, knee dysfunction and pain degree were more significant in the transpatellar group than the medial parapatellar and lateral parapatellar groups. These findings indicate that intramedullary nail fixation via the medial parapatellar and lateral parapatellar approaches leads to a better knee function and a lower incidence rate of patellar tendon and fat pad damage.

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