外固定支架联合有限内固定治疗Rüedi-Allgower Ⅲ型胫骨Pilon骨折的临床疗效分析以及经验初探  

Analysis of the clinical efficacy and experience of external fixation combined with limited internal fixation for the treatment of Rüedi-Allgower Ⅲ tibial Pilon fracture

作　　者：郑华庆[1] 周荣魁[1] 焦亚军[1] 黄磊[1] 陈昌红[1] 

机构地区：[1]南京中医药大学附属江阴医院,江阴市中医院骨科,江苏江阴214400

出　　处：《临床和实验医学杂志》2016年第22期2258-2261,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的研究比较两种内固定方式治疗Rüedi-Allg?werⅢ型胫骨Pilon骨折的临床疗效,总结个人对于复杂性胫骨Pilon骨折的经验。方法选取2011年3月至2015月6月收治的32例Rüedi-Allg?werⅢ型胫骨Pilon骨折患者作为研究对象。按照数字单双号分为观察组和对照组,每组16例。观察组患者给予外固定支架联合有限内固定治疗,对照组患者给予切开复位内固定治疗。比较两组患者的手术相关指标、临床踝关节复位情况和术后3个月并发症发生率。结果 (1)手术相关指标方面:两组患者手术时间、骨折愈合时间比较差异无显著性,但观察组术中出血量明显优于对照组,差异均具有统计学意义(P<0.05)。(2)Mazur评分情况:观察组患者Mazur评分为优良者的比率87.5%(14/16)均明显高于对照组75.0%(12/16),差异具有统计学意义(P<0.05)。(3)观察组患者术后并发症发生率为12.5%(2/16),低于对照组的并发症发生率25.0%(4/16),差异有统计学意义(P<0.05)。结论与切开复位内固定相比较,外固定支架联合有限内固定治疗Rüedi-Allg?werⅢ型胫骨Pilon骨折效果更好,复位效果好,术后恢复快,并发症发生率低,值得临床推广应用。Objective To compare and study the clinical efficacy of two fixation methods for the treatment of the Ruedi - Allgower type III tibial Pilon fractures, as well as personal experience to explore the complexity tibial Pilon fractures. Methods 32 cases of Rtiedi - Allgower type III tibial Pilon fracture patients from March 2011 to June 2015 were selected as objects in this study. They were divided into two groups according to digital odd and even numbers, 16 cases in each group. Observation group patients performed external fixator combined with limited internal fixation for the treatment, control group patients were treated with open reduction and internal fixation. Surgery -related indicators, reset clinical efficacy and complications between the two groups were observed and compared. Results ①Surgery - related indicators： operation time, fracture healing time was compared between the groups, the difference was not statistically significant. The blood loss in the observation group was lower the than that in control group, the difference was statistically significant （ P 〈 0.05 ）. ②Mazur Rating： the excellent rate of Mazur in observation group were better than control group [ 87.5% （14/16） vs. 75.0% （12/16） ], the difference was statistically significant （ P 〈 0.05 ）. ③The postoperative complication rate in observed group （12.5%） were lower than that in the control group （25.0%）, the difference was statistically significant （ P 〈 0.05）. Conclusion Compared with open reduction and internal fixed, external fixation combined with limited internal fixation in the treatment of Rtiedi - Allgower type III tibial Pilon fractures had good reset effect, rapid postoperative recovery, fewer complications. There-fore, it is worthy of clinical application.

关 键 词：胫骨PILON骨折 Rüedi-AllgowerⅢ型 外固定支架 有限内固定 切开复位内固定 

分 类 号：R687.3[医药卫生—骨科学]