前内侧联合后外侧入路治疗AO-C3型Pilon骨折的疗效观察  

The efficacy of anteromedial combined with posterolateral approach in the treatment of AO-C3 pilon fractures

作　　者：王聪 马敬祖[1] 罗小海 马宁[1] 魏松英[1] WANG Cong;MA Jingzu;LUO Xiaohai;MA Ning;WEI Songying(Department of Orthopedics,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院骨科,宁夏银川750002

出　　处：《宁夏医学杂志》2024年第11期972-975,共4页Ningxia Medical Journal

摘　　要：目的 探讨前内侧联合后外侧治疗AO-C3型Pilon骨折的早期临床疗效。方法 回顾性分析因外伤导致胫骨骨折患者资料,共纳入AO-C3型Pilon骨折患者50例,依据切口选择分为前外侧联合后内侧入路组(26例)和前内侧联合后外侧入路组(24例),对比2组患者在性别、住院时间、年龄、手术时间、术中出血量、功能锻炼时机、疼痛视觉模拟量表评分、伯威尔-夏恩利放射学骨折复位质量评价、美国足踝功能评分系统评分和手术并发症。结果 前外侧联合后内侧入路组患者手术时间为(142.77±14.26)min,长于前内侧联合后外侧入路组患者的(111.83±8.87)min, 2组比较差异有统计学意义(P<0.05);前外侧联合后内侧入路组患者术中平均出血量为(300.92±30.03)mL,前外侧联合后内侧入路组患者平均住院时间为(13.23±2.5)d,高于前内侧联合后外侧入路组患者的(197.29±16.23)mL,长于前内侧联合外侧入路组患者的(9.79±1.74)d, 2组比较差异有统计学意义(P<0.05);前外侧联合后内侧入路患者术后1个月、6个月踝关节功能评分(AOFAS)均低于前内侧联合后外侧入路组患者(P<0.05);前内侧联合后外侧入路组患者骨折愈合时间优于前外侧联合后内侧入路组患者;前内侧联合后外侧入路组患者在功能锻炼时机上优于前外侧联合后内侧入路组患者(P<0.05)。结论 在治疗AO-C3型pilon骨折的手术入路选择上,前内侧联合后外侧入路在围术期出血量、术后并发症、踝关节功能、功能锻炼时机等方面优于前外侧联合前内侧入路,值得临床推广应用。Objective To explore the early clinical effect of anterior medial combined with posterior lateral in the treatment of AO-C3 Pilon fracture.Methods The patients with tibial fracture were included in the study and data were retrospectively analyzed,and total of 50 patients with AO-C3 type Pilon fracture were divided into 26 cases in the anterolateral combined posterior medial approach group and 24 cases in the anteromedial combined posterior lateral.Two groups of patients were compared in terms of gender,length of hospitalization,age,duration of surgery,intraoperative blood loss,timing of functional exercise,pain visual analog scale score,Burwell-Shanley radiology fracture redundancy quality assessment,American ankle function score system and surgical complications.Results The operation time of the anterolateral combined posterior medial approach group was(142.77±14.26)min,higher than that of the anterior medial combined posterior lateral approach group(111.83±8.87)min(P<0.05).The average intraoperative bleeding volume of the anterolateral combined posterior medial approach group was(300.92±30.03)mL and the average hospitalization time was(13.23±2.5)day,higher than those of the anterior medial access group(197.29±16.23)mL and(9.79±1.74)day(P<0.05).The ankle joint function score of patients treated by anterolateral combined posterior medial approach was lower than that of patients treated by anterolateral combined posterior lateral approach at the first month and 6th months after operation(P<0.05).The fracture healing time of patients in the anterior medial combined posterior lateral approach group was better than that of patients treated by anterolateral combined posterior medial approach group,and the anterior medial combined posterior lateral approach was better than that of patients treated by anterolateral combined posterior medial approach group in terms of the timing of the functional exercise(P<0.05).Conclusion In the choice of surgical access for the treatment of AO-C3 pilon fractures,the anterolatera

关 键 词：PILON骨折 前内侧联合后外侧入路 前外侧联合后内侧入路 

分 类 号：R687.3[医药卫生—骨科学]