选择性胫骨远端关节周围骨折髓内钉治疗后的疗效

Anokha A Padubidri, Anthony T Sorkin, Andrew Gudeman, Roman M Natoli, Greg E Gaski
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摘要

胫骨远端关节周围骨折的髓内钉(IMN)与钢板固定相比可能更具优势。本研究旨在报告特定胫骨远端关节周围骨折的髓内钉治疗效果。研究纳入了在一级创伤中心接受IMN治疗的17岁以上胫骨远端关节外骨折(Osteosynthesefragen/Orthopaedic Trauma Association [AO/OTA] 43-A)、部分关节并伴有节段轴组件(43-B)和单纯关节内骨折(43-C1/2)的患者。主要结果是通过患者报告结果测量信息系统(PROMIS)评估的身体功能(PF)和疼痛干扰(PI)。次要结果包括再手术、不愈合、感染和错位。84名患者的随访时间超过12个月。PROMIS PI 和 PF 平均得分分别为 55.5 分和 45.0 分。未愈合率和深度感染率各为 8%。84%的患者达到了正常对位。与关节外骨折患者相比,关节内损伤患者的临床疗效没有差异。使用IMN治疗关节外和单纯关节内胫骨远端骨折后,预计可获得令人满意的临床、影像学和患者报告结果。(外科骨科进展杂志》32(4):246-251,2023 年)。
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Outcomes Following Intramedullary Nailing of Select Periarticular Distal Tibia Fractures.

Intramedullary nailing (IMN) of periarticular distal tibia fractures may offer advantages compared to plating. This study aims to report on the outcomes of select periarticular distal tibia fractures treated with IMN. Patients over 17 years of age that underwent IMN for extraarticular distal tibia fractures (Osteosynthesefragen/Orthopaedic Trauma Association [AO/OTA] 43-A), partial articular with associated segmental shaft component (43-B), and simple intraarticular (43-C1/2) at a Level I trauma center were included. The primary outcome was physical function (PF) and pain interference (PI) assessed via Patient-Reported Outcomes Measurement Information System (PROMIS). Secondary outcomes included reoperation, nonunion, infection, and malalignment. Eighty-four patients with > 12 months follow up were included. Mean PROMIS PI and PF scores were 55.5 and 45.0, respectively. The rate of nonunion and deep infection each were 8%. Eighty-four percent of patients achieved normal alignment. There were no differences detected in clinical outcomes between patients with intraarticular injuries compared with those with extraarticular fractures. Satisfactory clinical, radiographic, and patient-reported outcomes can be expected following treatment of extraarticular and simple intraarticular distal tibia fractures with IMN. (Journal of Surgical Orthopaedic Advances 32(4):246-251, 2023).

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