Suprapatellar nailing in complex Tibial Fractures.

IF 1.8 Q2 ORTHOPEDICS SICOT-J Pub Date : 2023-01-01 Epub Date: 2023-12-20 DOI:10.1051/sicotj/2023025
Wasudeo Gadegone, Piyush Gadegone, Vijayanand Lokhande
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Abstract

Purpose: This study evaluates the functional and radiological outcomes of segmental and comminuted tibial fractures using a suprapatellar approach in semi extended position.

Methods: A total of 62 patients, with a mean age of 40.8 (range: 21-78 yrs) and 43 males and 19 females, were retrospectively evaluated between January 2017 and December 2022. Patients with comminated tibial fracture AO Type 42 C3 (32) and segmental AO Type 42 C2 (21) AO Type 42 C1 (9) were treated with a IMN using the suprapatellar technique. There were 51 closed fractures and 11 grade-one open fractures. All patients were subjected to the suprapatellar nailing technique in the semi-extended position.

Results: Fracture healing 20.4 weeks on average was needed for the fracture to heal in segmental and 21.2 weeks in comminuted fracture. There were two instances of the delayed union in comminuted fractures. In two cases of segmental fracture dynamization is required. One case of non-union required bone grafting in a segmental fracture and in two instances in comminuted fractures to improve union after four months of monitoring. Primary union occurred in 56 patients. After minimum of 10.2 months of follow-up. According to Johner and Wruh's criteria with modifications, out of 62 patients, 47 had excellent results, 10 had good results, and 5 had fair results.

Conclusions: In segmental and comminuted fracture tibia, the suprapatellar IMN technique in a semi-extended position results in a significantly lower rate of malalignment, and good union because of soft tissue friendly bypass surgery.

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复杂胫骨骨折的髌上钉治疗。
目的:本研究评估了在半伸展位采用髌骨上入路治疗节段性和粉碎性胫骨骨折的功能和放射学结果:回顾性评估了 2017 年 1 月至 2022 年 12 月期间的 62 例患者,平均年龄为 40.8 岁(范围:21-78 岁),其中男性 43 例,女性 19 例。胫骨合并骨折AO 42型C3(32例)和节段性AO 42型C2(21例)AO 42型C1(9例)患者均采用髌上技术进行IMN治疗。其中 51 例为闭合性骨折,11 例为一级开放性骨折。所有患者都在半伸展位接受了髌上钉技术:节段性骨折愈合平均需要20.4周,粉碎性骨折愈合平均需要21.2周。有两例粉碎性骨折延迟愈合。有两例节段性骨折需要进行动力治疗。有一例节段性骨折未愈合需要植骨,有两例粉碎性骨折未愈合需要植骨,经过四个月的监测后,愈合情况有所改善。有 56 例患者发生了原发性愈合。经过至少 10.2 个月的随访。根据 Johner 和 Wruh 经修改的标准,62 例患者中,47 例效果极佳,10 例效果良好,5 例效果一般:结论:对于节段性和粉碎性胫骨骨折,在半伸直位采用髌上IMN技术可显著降低错位率,并且由于软组织友好的旁路手术,可获得良好的结合效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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