| 陈朝显,林雍智,刘晖,等.胫骨逆行髓内钉结合阻挡螺钉治疗超胫骨远端骨折的疗效分析.骨科,2025,16(6): 505-509. |
| 胫骨逆行髓内钉结合阻挡螺钉治疗超胫骨远端骨折的疗效分析 |
| Efficacy of retrograde intramedullary tibial nails combined with blocking screws in the treatment of ultra-distal tibial fractures |
| 投稿时间：2025-06-10 |
| DOI：10.3969/j.issn.1674-8573.2025.06.005 |
| 中文关键词: 超胫骨远端骨折 胫骨逆行髓内钉 阻挡螺钉 骨折复位 固定 |
| 英文关键词: Ultra-distal tibial fractures Retrograde intramedullary tibial nails Blocking screw Fracture reduction Fixation |
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| 中文摘要: |
| 目的 探讨胫骨逆行髓内钉（retrograde intramedullary tibial nails，RTN）结合阻挡螺钉治疗超胫骨远端骨折的临床疗效。方法 回顾性分析2021年1月至2024年6月在第九〇九医院骨科治疗的17例超胫骨远端骨折病人的临床资料，均采用闭合复位、不扩髓的RTN结合阻挡螺钉固定。记录病人骨折愈合时间、完全负重活动时间和骨折复位、并发症情况。末次随访时采用美国足踝外科医师协会（American Orthopaedic Foot and Ankle Society，AOFAS）踝与后足功能评分评估功能恢复情况。结果 所有病人术后均获随访，随访时间为（16.8±7.1）个月（12~25个月），骨折愈合时间为（4.5±1.2）个月（3~7个月），术后完全负重活动时间为（68.5±10.1）天（58~82天），末次随访时AOFAS评分为（83.1±9.3）分（72~93分）。在X线片上测量骨折在冠状面、矢状面平均成角均＜5°，无阻挡螺钉及RTN变形、断裂等情况。结论 通过缩小胫骨远端髓腔直径，阻挡螺钉可实现辅助RTN复位超胫骨远端骨折、提高固定稳定性的效果，具有良好的临床疗效。 |
| 英文摘要: |
| Objective To investigate the efficacy of retrograde intramedullary tibial nails (RTN) combined with blocking screws in the treatment of ultra-distal tibial fractures. Methods The clinical data of 17 patients with ultra-distal tibial fractures who received treatment in the Orthopedics Department of the 909th Hospital from January 2021 to June 2024 were analyzed retrospectively. All patients were treated with closed reduction and fixation using RTN combined with blocking screws. The patient's fracture healing time, complete weight-bearing activity time, fracture reduction, and complications were recorded. At the last follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Function Score was used to assess functional recovery. Results All patients were followed up for (16.8±7.1) months (12-25 months), the fractures healed in (4.5±1.2) months (3-7 months) after surgery, the postoperative full weight-bearing time was (68.5±10.1) days (58-82 days). At the last follow-up, the average AOFAS score was 83.1±9.3 (72-93). The average angulation of the fracture in the coronal plane and sagittal plane was less than 5° measured by X-ray and there was no blocking screw and RTN deformation and failure. Conclusion By reducing the diameter of the medullary cavity of the distal tibia, the blocking screw assisted RTN in reducing the ultra-distal tibial fractures and improving the stability of fixation, which has good clinical efficacy. |
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