复杂Pilon骨折患者后外侧联合前内侧入路手术治疗后骨代谢指标、踝关节功能及安全性分析  

Analysis of bone metabolism index,ankle function and safety of patients with surgical treatment of complex Pilon fracture through posterolateral combined anterolateral approach

作　　者：胡文帅 范文俊[1] 赵进喜[1] HU Wenshuai;FAN Wenjun;ZHAO Jinxi(Department of Joint Surgery,Macheng People's Hospital,Hubei,Macheng 438300,China)

机构地区：[1]湖北省麻城市人民医院关节外科,湖北麻城438300

出　　处：《中国医药科学》2021年第24期221-224,共4页China Medicine And Pharmacy

摘　　要：目的探讨复杂Pilon骨折患者后外侧联合前内侧入路手术治疗后骨代谢指标、踝关节功能及安全性。方法对2015年9月至2019年9月麻城市人民医院骨外科接收的100例复杂Pilon骨折合并腓骨骨折患者的数据资料进行回顾性分析,根据不同手术方式分为对照组(前外侧入路手术)、观察组(后外侧联合前内侧入路手术),每组各50例,比较两组手术相关性指标、术后复位效果、踝关节功能及骨代谢指标[血清骨钙素(BGP)、I型前胶原N-端前肽(PINP)及骨型碱性磷酸酶(BALP)]水平。结果观察组手术时间短、骨折愈合时间、完全负重时间均短于对照组,差异有统计学意义(P<0.05)。术后12个月,观察组患者复位效果、骨踝关节功能恢复效果明显优于对照组,差异有统计学意义(Z=2.074、2.760,P<0.05)。术后1个月,观察组患者血清BGP、BALP、PINP水平均明显高于对照组,差异有统计学意义(P<0.05)。结论后外侧联合前内侧入路应用于复杂Pilon骨折的临床效果显著,既可以有效改善患者骨折复位效果与踝关节功能,还可以加速骨折愈合,建议推广应用。Objective To investigate the bone metabolism index,ankle function and safety of patients with surgical treatment of complex Pilon fracture through posterolateral combined anterolateral approach.Methods The data of 100 patients with complex Pilon fracture complicated with fibular fracture presented to the Department of Orthopaedics,Macheng People's Hospital from September 2015 to September 2019 were analyzed retrospectively.They were divided into the control group(anterolateral approach)and the observation group(lateral combined anterolateral approach),with 50 cases in each group.The operation-related indexes,postoperative reduction effect,ankle function and bone metabolism index(serum bone gla protein[BGP],procollagen I N-terminal propeptide[PINP]and bone alkaline phosphatase[BALP])were compared between the two groups.Results The operation time,fracture healing time and complete weight bearing time of the observation group were shorter than those of the control group,with statistically significant differences(P<0.05).Twelve months after operation,the reduction effect and the recovery effect of ankle joint function in the observation group were obviously better than those in the control group,with statistically significant differences(Z=2.074,2.760,P<0.05).One month after operation,serum BGP,BALP and PINP levels in the observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Posterolateral combined anteromedial approach has a remarkable clinical effect in treating complex Pilon fracture,which can not only effectively promote fracture reduction and ankle function,but also accelerate fracture healing,which is worthy of popularizing in clinic.

关 键 词：复杂PILON骨折 手术入路 骨代谢 踝关节功能 

分 类 号：R687.3[医药卫生—骨科学]