后外侧联合前内侧入路治疗复杂Pilon骨折的临床效果  

Clinical effect of posterolateral combined anteromedial approach for the treatment of complex Pilon fractures

作　　者：刘中兵 张德荣 LIU Zhong-bing;ZHANG De-rong(Department of Orthopedics,Yancheng First People′s Hospital,Jiangsu Province,Yancheng224001,China)

机构地区：[1]江苏省盐城市第一人民医院骨科,江苏盐城224001

出　　处：《中国当代医药》2021年第35期83-86,共4页China Modern Medicine

摘　　要：目的探讨后外侧联合前内侧入路方式用于复杂Pilon骨折患者的临床治疗效果。方法回顾性选取2018年4月至2020年5月盐城市第一人民医院收治的48例复杂Pilon骨折患者作为研究对象,根据患者手术入路方式不同进行分为后外侧组(22例)与联合组(26例),后外侧组采用后外侧切口入路方式,联合组采用前内侧与后外侧双切口联合入路方式。比较两组的相关手术指标及患者术后疼痛程度、患肢肿胀消退效果、并发症发生情况等。结果联合组的平均手术时间、术后住院时间均长于后外侧组,患者术中出血量、术后引流量均多于后外侧组,患者术后骨折愈合时间短于后外侧组,差异有统计学意义(P<0.05);联合组术后1、2、3周视觉模拟评分法(VAS)分数均低于后外侧组,术后Mazur系统评分高于后外侧组,差异有统计学意义(P<0.05);联合组术后患肢肿胀消退总有效率高于后外侧组,术后相关并发症总发生率低于后外侧组,差异有统计学意义(P<0.05)。结论复杂Pilon骨折患者手术治疗中选用后外侧联合前内侧入路方式,可有效减轻患者术后疼痛及肿胀程度,促进患者术后踝关节症状及活动度的改善,同时能够有效减少术后并发症,有助于改善患者预后。Objective To evaluate the clinical effect of posterolateral combined anteromedial approach in the treatment of complex Pilon fractures.Methods A total of 48 patients with complex Pilon fracture admitted to Yancheng First People′s Hospital from April 2018 to May 2020 were selected retrospectively as the research objects.The patients were divided into posterolateral group(22 cases)and combined group(26 cases)according to different surgical approaches.The posterolateral group was treated with posterolateral approach and the combined group was treated with anterolateral and posterolateral approach.The related surgical indexes,postoperative pain degree,regression effect of swelling of affected limbs,incidence of complications were compared between the two groups.Results The average operation time and postoperative hospital stay of the combined group were longer than those of the posterolateral group,and the amount of bleeding and drainage of the combined group were more than those of the posterolateral group,and the fracture healing time of the combined group was shorter than that of posterolateral group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of the combined group were lower than those of the posterolateral group at 1,2 and 3 weeks after operation,and the Mazur score of the combined group was higher than that of the posterolateral group after operation,the differences were statistically significant(P<0.05).The regression effect of swelling of affected limbs of the combined group was higher than that of the posterolateral group,and the total incidence of postoperative complications of the combined group was lower than that of the posterolateral group,the differences were statistically significant(P<0.05).Conclusion Posterolateral combined anteromedial approach is used in the surgical treatment of complex Pilon fractures,can effectively reduce the postoperative pain and swelling,improve the postoperative ankle symptoms and mobility of patients,and can effectively re

关 键 词：复杂PILON骨折 后外侧入路 前内侧入路 疼痛 肿胀 并发症 

分 类 号：R683.4[医药卫生—骨科学]