两种手术入路治疗胫骨远端粉碎性骨折的疗效分析  

Effect analysis of two surgical approaches for the treatment of comminuted fracture of distal tibia

作　　者：朱孝勇 杨科 ZHU Xiao-yong;YANG Ke(Department of Orthopaedics Surgery,Lujiang County People′s Hospital,Lujiang Anhui 231500,China)

机构地区：[1]安徽省庐江县人民医院骨科,231500

出　　处：《蚌埠医学院学报》2023年第8期1076-1079,共4页Journal of Bengbu Medical College

摘　　要：目的:探索胫骨远端粉碎性骨折(Pilon骨折)的两种手术入路的治疗效果及其对踝关节功能的影响。方法:选择50例胫骨远端Pilon骨折病人作为研究对象,根据手术入路方式分组,对照组采用胫骨远端前外侧入路,观察组采用前内侧入路联合后外侧入路治疗,比较2组病人的围术期相关指标、术后影像学复位情况、术后临床治疗效果、术后功能恢复情况及不良反应情况。结果:2组手术时间、术中出血量差异无统计学意义(P>0.05),骨折愈合时间差异有统计学意义(P<0.05);通过对病人的术后影像学进行分析,按照Burwell-Charnley评价标准,对照组优良率明显低于观察组(P<0.05);术后2组病人根据Tornetta标准分析治疗效果,观察组优良率显著高于对照组(P<0.05);术后观察组Kofoed、AOFAS评分均显著高于对照组(P<0.01);2组术后不良反应发生情况差异无统计学意义(P>0.05)。结论:与采用胫骨远端前外侧入路方式比较,Pilon骨折采用前内侧入路联合后外侧入路治疗,更能有效改善病人的踝关节功能,缩短病人的术后恢复时间,且安全性较好。Objective:To investigate the therapeutic effect of two surgical approaches on distal tibial comminuted fracture(Pilon fracture)and its effect on ankle joint function.Methods:Fifty patients with Pilon fracture of distal tibia were selected as the study subjects and divided into observation group and control group according to the surgical approach.The control group was treated with anterolateral approach of distal tibia,and the observation group was treated with anterolateral approach combined with posterolateral approach.The perioperative relevant indexes,postoperative imaging reduction,postoperative clinical therapeutic effect,postoperative functional recovery and adverse reactions were compared between the two groups.Results:There was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05),but there was significant difference in fracture healing time between the two groups(P<0.05).According to Burwell-Charnley evaluation criteria,the excellent and good rate of the control group was significantly lower than that of the observation group(P<0.05).According to Tornetta standard analysis of treatment effect,the excellent and good rate of the observation group was significantly higher than that of the control group(P<0.05).Kofoed and AOFAS scores in the observation group were significantly higher than those in the control group(P<0.01).There was no significant difference in the occurrence of postoperative adverse reactions between the two groups(P>0.05).Conclusions:Compared with the anterolateral approach of the distal tibia,the anterolateral approach combined with posterolateral approach for Pilon fracture can effectively improve the ankle joint function,shorten the postoperative recovery time of patients,and have better safety.

关 键 词：胫骨远端粉碎性骨折 前内侧入路 后外侧入路 

分 类 号：R683.42[医药卫生—骨科学]