延期有限内固定结合外固定支架对高能量Pilon骨折患者关节功能的影响  

Effect of delayed limited internal fixation combined with external fixation on joint function of high energy Pilon fracture

作　　者：彭昊[1] 覃巍[2] 廉凯[2] 

机构地区：[1]武汉大学人民医院骨科,武汉430060 [2]湖北文理学院附属医院襄阳市中心医院骨科

出　　处：《骨科》2015年第6期310-313,共4页ORTHOPAEDICS

摘　　要：目的研究延期有限内固定结合外固定支架对高能量Pilon骨折患者关节功能与软组织损伤的影响。方法将2012年4月至2013年10月收治的高能量Pilon骨折患者90例纳入研究对象,根据治疗方法不同分为:接受延期有限内固定结合外固定支架治疗(观察组)和接受急诊有限内固定结合外固定支架治疗(对照组),比较两组患者的关节功能、术后恢复情况。结果术后6、9和12个月时,观察组Baird踝关节评分均明显高于对照组,差异均有统计学意义(均P<0.05);术后软组织肿胀消退时间、影像学完全愈合时间、完全负重下地时间均明显短于对照组,差异均有统计学意义(均P<0.05);并发症发生率(6.67%)明显低于对照组(48.89%),差异有统计学意义(χ2=19.994,P<0.01)。结论延期有限内固定结合外固定支架治疗有助于减少软组织损伤,促进骨折愈合,改善关节功能,提高治疗效果。Objective To study the effect of delayed limited internal fixation combined with external fixation on joint function and soft tissue injury of high energy Pilon fracture. Methods Ninety patients with high energy Pilon fracture in Orthopaedics Department of our hospital from Apr. 2012 to Oct. 2013 were enrolled in this study. According to the different treatment regimens, the patients were divided into observation group given delayed limited internal fixation combined with external fixation, and control group given emergency limited internal fixation combined with external fixation. The postopera- tive joint function and recovery were compared. Results At 3rd, 9th and 12th month after surgery, Baird ankle joint scores were significantly higher in observation group than in control group （all P〈0. 05）. Postoperative soft tissue swelling time, imaging complete healing time, and full weight bearing time were significantly shorter in observation group than in control group （all P〈0. 05）. The incidence of complication in observation group （6. 67%） was significantly lower than in control group （48. 89%, X^2 = 19. 994, P〈0. 01）. Conclusion Delayed limited internal fixation combined with external fixation contributes to reduce injury of soft tissue, promotes the healing of fracture, and improves joint function and therapeutic effect.

关 键 词：胫骨骨折 内固定器 外固定器 治疗结果 

分 类 号：R687.3[医药卫生—骨科学]