外固定结合二期内固定序贯治疗对C型Pilon骨折患者关节功能的影响  

Effect of sequential external fixation combined with secondary internal fixation on joint function in patients with type C Pilon fracture

作　　者：王锡雄[1] 蓝声远 郑志雄 李旭[1] 劳世高[1] WANG Xi-xiong;LAN Sheng-yuan;ZHENG Zhi-xiong;LI Xu;LAO Shi-gao(Department of Orthopedics,the First People's Hospital of Qinzhou,Qinzhou 535000,Guangxi,China)

机构地区：[1]钦州市第一人民医院骨科,广西钦州535000

出　　处：《川北医学院学报》2022年第7期891-893,897,共4页Journal of North Sichuan Medical College

基　　金：广西钦州市科学研究与技术开发计划项目(20202728)。

摘　　要：目的:探讨外固定结合二期内固定序贯治疗对C型Pilon骨折患者关节功能的影响。方法:将95例C型Pilon骨折患者根据手术方法不同分为序贯治疗组(n=50)和一期切开复位内固定(ORIF组,n=45);序贯治疗组采用外固定结合二期内固定序贯治疗,ORIF组采用ORIF治疗。对比两组治疗内固定手术时间、术中出血量、骨折愈合效果、术后6个月及12个月踝关节功能水平及切口感染、骨折延迟愈合的发生率。结果:序贯治疗组患者手术时间短于ORIF组,术中出血量少于ORIF组(P<0.05);序贯治疗组患者术后6个月骨折复位情况优于ORIF组(P<0.05);序贯治疗组患者术后6个月及12个月踝关节功能Baird评分均高于ORIF组(P<0.05);序贯治疗组患者术后切口感染、骨折延迟愈合及骨不连的并发症发生率低于ORIF组(P<0.05)。结论:外固定结合二期内固定序贯治疗C型Pilon骨折可显著降低患者手术时间及术中出血量,提高患者术后踝关节功能、降低术后切口感染及骨延迟愈合的发生率,临床优势较明确。Objective:To investigate the effect of sequential external fixation combined with secondary internal fixation on joint function in patients with type C Pilon fracture.Methods:A total of 95 patients with type C Pilon fracture were selected.According to surgical methods,they were divided into the sequential treatment group(n=50)with sequential treatment of internal and external fixation and the ORIF group(n=45)with open reduction and internal fixation(ORIF).The operative time of internal fixation,intraoperative blood loss,fracture healing effect,ankle function level and incision infection at 6 and 12 m after operation,and the incidence of delayed fracture healing were compared between the two groups.Results:The operation time in the sequential treatment group was significantly shorter than that in the ORIF group,and the intraoperative blood loss was significantly less than that in the ORIF group(P<0.05).The fracture reduction in the sequential treatment group was significantly better than that in the ORIF group at 6 m after operation(P<0.05).The Baird scores of ankle joint function at 6 and 12 m after operation in the sequential treatment group were significantly higher than those in the ORIF group(P<0.05).The incidence of postoperative wound infection,delayed fracture healing and nonunion in the sequential treatment group were significantly lower than those in the ORIF group(P<0.05).Conclusion:The sequential treatment of external fixation combined with secondary internal fixation for type C Pilon fractures can significantly reduce the operation time and intraoperative blood loss of patients,improve the postoperative ankle function of patients,and reduce the incidence of postoperative incision infection and delayed bone healing,with clear clinical advantages.

关 键 词：PILON骨折 序贯治疗 切开复位内固定 踝关节功能 并发症 疗效 

分 类 号：R683[医药卫生—骨科学] R687.3[医药卫生—外科学]