前外侧入路联合改良后内侧入路治疗老年Pilon骨折的临床疗效  

Clinical Efficacy of Anterolateral Approach Combined with Modified Posteromedial Approach in the Treatment of Pilon Fracture in the Elderly

作　　者：唐可[1] 刘晓晖 诸葛恒艳[1] 刘长增 Tang Ke;Liu Xiaohui;Zhuge Hengyan;Liu Changzeng(Department of Orthopedics,the 904th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Wuxi 214044)

机构地区：[1]中国人民解放军联勤保障部队第九○四医院骨科,无锡214044

出　　处：《国际老年医学杂志》2024年第6期698-701,共4页International Journal of Geriatrics

基　　金：江苏省科学技术厅基础研究项目(BK20210072)。

摘　　要：目的 探讨前外侧入路联合改良后内侧入路治疗老年Pilon骨折的临床疗效。方法 便利抽样法选取2016年1月—2021年12月中国人民解放军联勤保障部队第九○四医院收治的老年Pilon骨折患者130例进行回顾性分析。依据入路治疗方式分为对照组和观察组,各65例。对照组接受前外侧入路治疗,观察组接受前外侧入路联合改良后内侧入路治疗。记录两组手术时间、完全负重时间、骨折愈合时间、术中出血量、踝关节功能、解剖复位效果及术后1年内并发症发生情况。结果 观察组手术时间、完全负重时间、骨折愈合时间均短于对照组(P<0.05),两组术中出血量比较差异无统计学意义(P>0.05);观察组踝关节功能有效率高于对照组(P<0.05);观察组复位效果优于对照组(P<0.05);观察组术后1年并发症总发生率低于对照组(P<0.05)。结论 前外侧入路联合改良后内侧入路治疗老年Pilon骨折具有较好的临床疗效,能够缩短手术时间、完全负重时间和骨折愈合时间,提高踝关节功能有效率和解剖复位效果,有效保护踝关节软组织,进而避免内固定物外露及软组织坏死等。Objective To investigate the clinical effect of anterolateral approach combined with modified posteromedial approach in the treatment of Pilon fracture in the elderly.Methods A total of 130 elderly patients with Pilon fracture admitted to the 904th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2016 to December 2021 were selected by convenience sampling method for retrospective analysis.They were divided into control group and observation group according to the approach treatment,with 65 cases in each group.The control group received anterolateral and the observation group received anterolateral approach combined with modified posteromedial approach.The operation time,full weight-bearing time,fracture healing time,intraoperative blood loss,ankle joint function,anatomical reduction effect and complications within 1 year after operation were recorded in the two groups.Results The operation time,full weight-bearing time and fracture healing time in observation group were shorter than those in control group(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).The effective rate of ankle joint function in observation group was higher than that in control group(P<0.05).The reduction effect in observation group was better than that in control group(P<0.05).The total incidence rate of complications 1 year after operation in observation group was lower than that in control group(P<0.05).Conclusion Anterolateral approach combined with modified posteromedial approach has a good clinical effect in the treatment of Pilon fracture in the elderly.It can shorten the operation time,full weight-bearing time and fracture healing time,improve the effective rate of ankle joint function and anatomical reduction effect,effectively protect the ankle joint soft tissue,and then avoid the exposure of internal fixation and soft tissue necrosis.

关 键 词：PILON骨折 前外侧入路 改良后内侧入路 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]