骨骨折的下骨与上骨钉 (INSURT研究):一个多中心随机对照试验
David J Cinats1, Darius Viskontas1, Trevor Stone1
1Royal Columbian Hospital, Department of Orthopaedics, University of British Columbia, Canada.
Journal of orthopaedic trauma
|June 12, 2025
概括
上上的钉钉提供了与下相比更好的膝盖承重能力,尽管这两种方法在手术后的膝盖疼痛中没有显著差异. 患者应被告知膝盖能力和指甲插入技术.
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理 创伤护理
- 生物力学 生物力学
背景情况:
- 骨折是常见的伤害,需要手术干预.
- 内钉是骨骨折的标准治疗方法.
- 选择的指甲插入方法 (上指甲和下指甲) 可能会影响患者的治疗结果.
研究的目的:
- 为了比较手术后的膝盖疼痛和上上下下上爪插入之间的功能结果.
- 为了评估钉子插入方法在跪下时对承重能力的影响.
主要方法:
- 进行了一项多中心,随机对照试验 (I级证据).
- 254名患有OTA/AO类型42和43A骨折的患者 (18-65岁) 被随机分类.
- 主要结局:跪后膝盖疼痛的视觉模拟尺度 (VAS);次要结局:阿伯丁跪/站立测试,Lysholm,EQ-5D,WPAI.
主要成果:
- 在多个时间点 (长达一年) 上,上钉显示出统计学上显著的较低VAS评分,用于膝盖疼痛,但差异在临床上并不显著.
- 在手术后的两年内,在阿伯丁膝盖测试中,上皮皮组的患者通过手术膝盖显著增加了承重能力.
结论:
- 在两种方法之间,膝关节疼痛 (VAS) 或患者报告的结果测量 (PROM) 没有临床显著的差异.
- 上的钉钉使得通过手术后的手术膝盖更好地承受重量.
- 建议为患者提供有关膝盖能力和指甲插入技术的知情咨询.
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