锁定钢板微创内固定治疗Ⅱ、Ⅲ型pilon骨折研究  

Minimally Invasive Internal Fixation of Locked Plate For the Treatment of Ⅱ and Ⅲ Pilon Fractures

作　　者：巫彬彬 彭济河 林彩龙 徐晶 陈文忠 WU Bin-bin;PENG Ji-he;LIN Cai-long;XU Jing;CHEN Wen-zhong(Orthopedics,People＇s Hospital of Fengshun County,Guangdong Province,Fengshun 514300 China)

机构地区：[1]广东省丰顺县人民医院骨科,广东丰顺514300

出　　处：《内蒙古医学杂志》2018年第5期522-524,共3页Inner Mongolia Medical Journal

基　　金：梅州市社会发展科技计划项目(2017B172)

摘　　要：目的比较锁定钢板微创内固定与普通L型钢板切开复位内固定术治疗Ⅱ、Ⅲ型pilon骨折的疗效。方法对2016年3月至2018年1月在我院就诊的Ⅱ、Ⅲ型pilon骨折患者中选出56例,以随机数字表法分组,对照组采用常规普通L型钢板切开复位内固定术,治疗组采用锁定钢板微创内固定术,对比两组的手术相关指标、术后踝关节功能评分等。结果治疗组在手术指标(手术时间、术中出血量)上均优于对照组(P<0.05);术后切口不良反应发生率治疗组3.57%,显著低于对照组的21.43%(P<0.05);治疗组的骨折愈合时间短于对照组,且术后6个月复查,治疗组患者的踝关节功能Kofoed评分明显高于对照组(P<0.05)。结论相较于传统的L型钢板切开复位内固定术,锁定钢板微创内固定术对Ⅱ、Ⅲ型pilon骨折患者的创伤更小,利于术后的康复,值得推广。Objective To compare the effect of minimally invasive internal fixation with locking plate and open reduction and internal fixation with L-shaped plate for the treatment of type Ⅱ and Ⅲ pilon fractures.Methods Fifty-two cases of type Ⅱ and Ⅲ pilon fractures diagnosed in our hospital from March 2016 to January 2018 were randomly selected and grouped by random number table method. The control group was treated with conventional L-shaped steel plate for open reduction and internal fixation. The minimally invasive internal fixation was performed on the locking plate in the treatment and treatment groups,and the related indexes of the two groups and the postoperative ankle joint function scores were compared. Results In the treatment group,the surgical index（ operation time,intraoperative blood loss） were better than the control group（ P〈 0. 05）; the incidence of postoperative incision adverse reactions in the treatment group was 3. 57%,which was significantly lower than the control group 21. 43%（ P〈 0. 05）; The fracture healing time of the treatment group was shorter than that of the control group,and the Kofoed score of the ankle joint function of the treatment group was significantly higher than that of the control group（ P〈 0. 05）. Conclusion Compared with the traditional L-shaped steel plate for open reduction and internal fixation,the minimally invasive internal fixation with locking plate is less invasive for patients with type II and III pilon fractures,which is beneficial for postoperative rehabilitation and worthy of promotion.

关 键 词：锁定钢板微创内固定 常规L型钢板 PILON骨折 踝关节Kofoed评分 

分 类 号：R683.42[医药卫生—骨科学]