Comparision Of Suprapatellar Approach And Transtendinous Approach Nailing Treatment In Tibal Shaft Fractures

Objective:In this clinical study,we aimed to retrospective analysis comparision of suprapatellar approach and transtendinous approach nailing treatment in tibal shaft fractures.To verify whether the suprapatellar approach nailing in the treatment of tibial shaft fractures can reduce the incidence of postoperative complications,improve the clinical treatment effect.To facilitate future treatment of tibial shaft fracture can choose a more appropriate surgical and promoted.Methods:Rretrospective analysis from June 2013 to January 2015,72 patients with unilateral tibia shaft closed fracture received intramedullary nail fixation treatment.There were 40 males and 32 females with mean age of 48.38 years old and 33 patients approach transtendinous,39 patients approach suprapatellar.Comparison of two approaches were followed up for treatment of tibial shaft fracture healing time, the use of Johner-Wruhs score compare their clinical healing effect, visual analogue score(Visual analog scales) on postoperative knee pain score,application of statistical methods on patient age, gender, intramedullary nail diameter, VAS score, fracture healing time and the rate of excellent and good,incidence of postoperative knee pain, etc. were evaluated.Results:The transtendinous approach group fracture healing time(83.1 + 6.3 d) and suprapatellar approach group fracture healing time(82.3 + 6.7 d),no significant difference( P > 0.05) was found.Johner-Wruhs rated excellent rate:he transtendinous approach group 93.9%,suprapatellar approach group 94.9%,the difference was not statistically significant(P> 0.05). 18 cases experienced knee pain,36.4 percent of patients treated with transtendinous nailing reported knee pain,and 15.4 percent of patients treated with suprapatellar nailing reported knee pain.Significant difference( P < 0.05) was found.In cases of knee pain,VAS score of patients treated with transtendinous nailing was(3.4±1.1),suprapatellar nailing was(3.7±0.9),no significant difference( P > 0.05) was found.Conclusion:This paper retrospective analysis comparision of suprapatellar approach and transtendinous approach nailing treatment in tibal shaft fractures,the results show that the two are good.But the suprapatellar approach of intramedullary nailing for the treatment of tibial shaft fractures can reduce the postoperative pain of knee joint.The suprapatellar approach of intramedullary nailing has certain advantages in the surgical treatment of tibial shaft fracture, it is worthy of clinical promotion.