Chinese Journal of Tissue Engineering Research ›› 2017, Vol. 21 ›› Issue (27): 4336-4341.doi: 10.3969/j.issn.2095-4344.2017.27.013
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Zhang Jing, Ma Jiang-wei
Online:
2017-09-28
Published:
2017-10-24
Contact:
Ma Jiang-wei, Master, Associate chief physician, Department of Orthopedics, the First Hospital of Yulin, Yulin 610802, Shaanxi Province, China
About author:
Zhang Jing, Master, Physician, Department of Orthopedics, the First Hospital of Yulin, Yulin 610802, Shaanxi Province, China
CLC Number:
Zhang Jing, Ma Jiang-wei. Magnetic navigation META-NAIL interlocking intramedullary nailing for tibial shaft fractures via the supra-patellar approach [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(27): 4336-4341.
2.2 Lysholm评分 患者术前Lysholm评分平均50分,术后24周Lysholm评分为83-95分,平均90分。用Johner-Wruh标准评价患者术后功能恢复情况,临床优良率约为95%。 2.3 患者手术时间、出血量及住院时间 患者的手术时间为55-80 min,平均为65 min;出血量为10-80 mL,平均为30 mL;术后住院时间为3-10 d,平均7.2 d。 2.4 骨折愈合时间及疼痛情况 患者骨折平均愈合时间为85 d,术后随访中无患者出现患肢膝前疼痛。 2.5 并发症 所有患者术后14 d伤口拆线,未出现伤口不愈合、感染等情况;未出现骨折不愈合、延迟愈合、骨髓炎、畸形愈合等并发症。 2.6 典型病例 患者,男,43岁,因车祸导致右闭合型胫腓骨骨折,患处皮肤肿胀,小腿畸形明显,有反常活动,形成假关节。入院后给予患者跟骨牵引、消肿止痛、抬高患肢、患处冷敷等对症处理。待患肢肿胀消退产生皮纹后行手术治疗。患者在硬膜外麻醉下行磁导航META髓内钉髌上入路置入髓内钉治疗,手术过程顺利(见图2)。患者的手术时间约为60 min,出血量约为35 mL。术后复查平片显示胫骨干骨折解剖复位,术后鼓励患者行早期功能锻炼,预防深静脉血栓形成,患者对手术效果满意,术后3 d患者遵医嘱出院。 患者出院后前3个月每个月门诊复查1次,3个月后约2个月复查1次。术后2个月开始行部分负重功能锻炼,术后3个月开始行完全负重功能锻炼。术后6个月胫骨干骨折断端完全愈合,患者康复过程中未出现膝前疼痛、切口感染、下肢深静脉血栓及骨髓炎等并发症。 "
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