改良后外侧入路支撑钢板治疗后侧Pilon骨折患者的临床疗效及安全性分析  

Clinical study of improved posterolateral approach supporting plate in treatment of posterior Pilon fractures

作　　者：何嘉承[1] 李强[1] 喻巍 周欢斌 傅江明 周志刚[1] He Jiacheng;Li Qiang;Yu Wei;Zhou Huanbin;Fu Jiangming;Zhou Zhigang(Department of Orthopaedics,Jiujiang First People' s Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院骨科,江西九江332000

出　　处：《当代医学》2019年第5期18-20,共3页Contemporary Medicine

摘　　要：目的探讨改良后外侧入路支撑钢板在后侧Pilon骨折治疗中的临床价值。方法选取本院2011年10月至2017年10月收治的后侧Pilon骨折患者28例为研究对象,按照不同内固定治疗方法将其分为观察组(15例)和对照组(13例),观察组采取改良后外侧入路支撑钢板治疗,对照组采取由前向后空心钉固定治疗,观察两组治疗情况,随访6～12个月,评价患者骨折愈合情况,采用美国足踝外科协会(AO‐FAS)评分系统评价患者的踝关节功能,统计两组术后并发症发生情况。结果两组手术时间、住院时间差异无统计学意义;在骨折愈合时间方面,观察组明显短于对照组(P<0.05);观察组AOFAS评分显著高于对照组(P<0.05),而两组AOFAS疗效比较差异无统计学意义;对照组切口延迟愈合、骨折再移位等并发症发生率(15.4%)与观察组(6.7%)比较差异无统计学意义。结论改良后外侧入路支撑钢板治疗后侧Pilon骨折,临床疗效确切,内固定效果好,有较高的应用价值。Objective To explore the clinical value of modified posterolateral approach supporting plate in the treatment of posterior Pilon fractures.Methods 28 patients with posterior Pilon fractures treated in our hospital from October 2011 to October 2017 were selected as the research subjects.They were divided into observation group(n=15 cases)and control group(n=13 cases)according to different internal fixation methods.The observation group was treated with modified posterior lateral approach,while the control group was treated with anterior and posterior cannulated screw fixation.Observe the two groups of treatment,followed up for 6-12 months,evaluate the healing of fracture.The ankle joint function of the two groups was evaluated by the American foot and ankle surgery association(AOFAS)scoring system.Results In terms of operative time and length of stay,the two groups were almost equal.At the time of fracture healing,the observation group was significantly shorter than the control group(P<0.05);The AOFAS score of the observation group was significantly higher than that of the control group(P<0.05),but there was no significant difference in the AOFAS effect between the two groups.In the control group,the incidence of delayed wound healing,fracture displacement and other complications(15.4%)was not significantly different from that of the observation group(6.7%).Conclusion Improved posterior lateral approach supporting plate for posterior Pilon fractures has definite clinical efficacy,good internal fixation effect and high application value.

关 键 词：骨折 后外侧入路 支撑钢板 骨折愈合 

分 类 号：R687.3[医药卫生—骨科学]