Pilon骨折中腓骨骨折类型对胫骨内固定钢板放置位置的评估  

Evaluation of the type of fibular fracture for the location of tibial fixation of Pilon fractures

作　　者：王喜良[1] 冯晓东[1] 周荣兴[1] 郭军[1] 吕慧成[1] 常志强[1] WANG Xiliang;FENG Xiaodong;ZHOU Rongxing;GUO Jun;LYU Huicheng;CHANG Zhiqiang(Area B,Trauma Center,the Second Affiliated Hospital of Inner Mongolia Medical University,Inner Mongolia,Hohhot,010030,China)

机构地区：[1]内蒙古医科大学第二附属医院创伤中心B区,内蒙古呼和浩特010030

出　　处：《当代医学》2022年第7期71-74,共4页Contemporary Medicine

摘　　要：目的研究评估Pilon骨折中腓骨骨折类型对胫骨内固定钢板放置位置的影响。方法选取2011年7月至2019年6月于本院门急诊收治的Pilon骨折患者102例。随访时间>6个月、<1年的有80例(A组),随访>1年的有22例骨折(B组);对腓骨骨折进行内固定的有87例,粉碎性骨折58例(外翻组),横行骨折29例(内翻组),比较胫骨钢板固定的位置及术后并发症发生情况。结果内翻组中,胫骨骨折采用内侧钢板的机械并发症为14.3%,低于采用外侧钢板的80.0%(P=0.006)。外翻组中,胫骨骨折采用内侧钢板的机械并发症为36.4%,采用外侧钢板的机械并发症为16.7%,两组比较差异无统计学意义(P=0.156)。结论在Pilon骨折的治疗中,为降低术后机械并发症的发生,临床中应以抵抗原始变形力的方式放置胫骨内固定钢板。Objective The purpose of this study was to identify optimal plate location for fixation of Pilon fractures based on the orientation of the fibular fracture.Methods A total of 102 patients with Pilon fracture who were admitted to the outpatient and emergency department of our hospital from July 2011 to June 2019 were selected.There were 80 cases of follow-up>6 months and<1 year(group A),and 22 cases of fractures(group B)were followed up for>1 year;87 cases of fibula fractures underwent internal fixation,and 58 cases of comminuted fractures(valgus group),29 cases of transverse fractures(varus group),the position of tibial plate fixation and postoperative complications were compared.Results For the transverse fibula group,14.3%mechanical complications were noted for medially placed plate vs 80%for lateral plating(P=0.006).For the comminuted fibular group,36.4%of medially placed plates demonstrated mechanical complications vs 16.7%for laterally based plates(P=0.156).Conclusion To limit mechanical complications,tibial plates should be applied in such a way as to resist the original deforming forces.

关 键 词：PILON骨折 腓骨骨折类型 胫骨远端 胫骨远端钢板 

分 类 号：R687.3[医药卫生—骨科学]