| 王金鹏,孙 琦,李亚强,周海超,郑龙坡.胫骨髓内钉入路治疗胫骨干骨折的临床进展[J].,2017,17(25):4971-4974 |
| 胫骨髓内钉入路治疗胫骨干骨折的临床进展 |
| Progress about Surgical Approach in Treatment of Tibia Shaft Fracture with Intramedullary Nail |
| 投稿时间：2017-03-09 修订日期：2017-04-06 |
| DOI：10.13241/j.cnki.pmb.2017.25.042 |
| 中文关键词: 胫骨骨干骨折 髌骨上入路 髌骨下入路 髓内钉固定 |
| 英文关键词: Tibia shaft fracture Supra-patellar approach Infra-patellar approach Intramedullary nail |
| 基金项目:国家自然科学基金项目（81541055 ） |
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| 中文摘要: |
| 摘要：胫骨干骨折是最常见的长骨骨折，对于不稳定的胫骨骨折，胫骨髓内钉因其独特的优势逐渐成为首选治疗方式。当前对于胫骨干髓内钉入路主要分为髌骨上入路和髌骨下入路。髌骨上入路放置髓内钉时，患肢半伸直位有利于胫骨干骨折的复位与固定，但可能会造成髌骨关节面损伤。髌骨下入路患肢屈曲位可能会造成胫骨干复位的丢失，进而影响患者的预后。因此，胫骨髓内钉置入不同入路可能造成不同临床结局，会对临床结局造成不同的影响。目前对于胫骨髓内钉最佳入路仍然存在争议，针对最近发表的相关文献我们对胫骨髓内钉入路及其优缺点进行讨论综述。 |
| 英文摘要: |
| ABSTRACT: Tibia shaft fracture is the most common long bone fractures clinically and intramedullary nail fixation is the best choice due to superior biomechanical characteristics for unstable tibia shaft fractures. At present, the common approaches for intram- edullary nail insertion are divided into supra-patellar approach and infra-patellar approach. The semi-extended position of supra-patellar approach contributes to better fracture reduction but lead to potential patella-femoral cartilage injury. In contrast, flexion or hyper-flexion position of infra-patellar approach might result in unsatisfactory fracture reduction, then have an impact on clinical outcome. Therefore, the clinical outcome might be different because of approach choice. However, there is no consensus about the optimal surgical approach for intramedullary nailing. Thus, we performed the review to discuss the approaches for tibia intramedullary nailing and compare their strengths and weaknesses. |
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