改良双切口锁定加压钢板固定治疗高能量闭合性Pilon骨折疗效分析  

The analysis of improved double incision with locking compression plate in the treatment of high-energy closed Pilon fracture

作　　者：陈伟练[1] 黎俊豪 郑伟坤[1] CHEN Wei-lian;LI Jun-hao;ZHENG Wei-kun(Department of Orthopedics,Nansha Medical Center of Guangzhou First People＇s Hospital,Guangzhou 510000,China)

机构地区：[1]广州市第一人民医院南沙医院骨科,广东510000

出　　处：《创伤外科杂志》2018年第11期855-858,共4页Journal of Traumatic Surgery

摘　　要：目的探究改良双切口锁定加压钢板固定对于高能量闭合性Pilon骨折的治疗效果。方法回顾性分析2014年1月—2016年1月广州市第一人民医院南沙医院骨科收治的高能量闭合性Pilon骨折患者68例,其中接受传统手术治疗34例(采用传统的前内侧入路联合腓骨入路,先行腓骨骨折端复位,再行关节面复位,传统组),接受改良双切口锁定加压钢板固定治疗34例(采用改良的前正中切口联合后外侧入路锁定加压钢板固定,改良组),通过查阅临床病例,比较两组的治疗效果。结果改良组术中出血量、手术时间、手术切口长度较传统组差异均无统计学意义(P> 0. 05);术后3个月复查X线片,改良组解剖复位率为88. 2%,高于传统组的70. 6%,差异有统计学意义(χ~2=3. 238,P <0. 05);改良组骨折愈合时间、重返工作岗位时间少于传统组,且并发症发生率较低,差异有统计学意义(P <0. 05);改良组疗效优良率为88. 2%,高于传统组的70. 6%,差异有统计学意义(P <0. 05)。结论改良双切口锁定加压钢板固定可提高高能量闭合性Pilon骨折复位效果,减少康复时间和并发症,疗效显著,值得临床推广使用。Objective To investigate the effect of modified double-incision locking compression plate fixation on high-energy closed Pilon fractures. Methods A retrospective analysis was conducted in 68 patients with high-energy closed Pilon fractures admitted to the Department of Orthopaedics of Nansha Medical Center of Guangzhou First People s Hospital from Jan. 2014 to Jan. 2016. Among them,34 patients underwent conventional surgery （the traditional anterior medial approach combined with the humeral approach was used,the humerus fracture end was first restored,and then the articular surface was restored,conventional group）,and 34 cases were treated with modified double incision locking compression plate fixation （modified anterior median incision combined with posterolateral approach was used,modified group）. The treatment effects of the two groups were compared. Results There was no significant difference in the amount of bleeding,operation time and length of surgical incision in the modified group （ P 〉0.05）. The X-ray films were reviewed 3 months after operation,the anatomic reduction rate of the modified group was 88.2%,higher than in the traditional group（70.6%）,and the difference was statistically significant （ χ 2 =3.238, P 〈0.05）. The fracture healing time and return to work time in the modified group were less than those of the traditional group,the complication rate was lower,and the difference was statistically significant （ P 〈0.05）; the excellent and good rate of the modified group was 88.2%,which was higher than that of the traditional group （70.6%）,and the difference was statistically significant （ P 〈0.05）. Conclusion Modified double-incision locking compression plate fixation can improve the reduction of high-energy closed Pilon fracture,reduce the recovery time and complications,and the curative effect is significant. It is worthy of clinical promotion.

关 键 词：PILON骨折 双切口 加压钢板 内固定 

分 类 号：R683.42[医药卫生—骨科学]