Pilon骨折数字规划开放复位内固定  

Digital planning open reduction internal fixation of Pilon fractures

作　　者：董美淇 李南[2] 王明绪[2] 孟祥启[2] 王国栋 DONG Mei-qi;LI Nan;WANG Ming-xu;MENG Xiangqi;WANG Guo-dong(Training Center of Kangda College,Nanjing Medical University,Lianyungang,Jiangsu 222000,China;Depart-ment of Traumatic Orthopaedics,People's Hospital of Ganyu District,Lianyungang,Jiangsu,221000,Jiangsu,China)

机构地区：[1]南京医科大学康达学院实训中心,江苏连云港222000 [2]连云港市赣榆区人民医院创伤骨科,江苏连云港221000

出　　处：《中国矫形外科杂志》2024年第24期2240-2245,共6页Orthopedic Journal of China

基　　金：南京医科大学康达学院2023年度科研发展基金项目(编号:KD2023KYJJ129);江苏省基础研究计划(自然科学基金)项目(编号:BK20201221)。

摘　　要：[目的]探讨数字化骨科技术在Pilon骨折内固定中的临床应用。[方法]选取2019年5月—2022年5月接诊的Pilon骨折患者102例,随机分为两组,规划组51例术前采用数字化骨科技术模拟骨折复位,常规组51例接受常规后Pilon骨折内固定治疗,比较两组的围手术期、随访及影像学结果。[结果]规划组手术时间[(93.6±18.0)min vs(107.6±20.3)min,P<0.001]、切口总长度[(14.6±2.9)cm vs(17.2±3.4)cm,P<0.001]、术中失血量[(72.6±19.4)ml vs(87.2±20.5)ml,P<0.001]、术中透视次数[(4.8±1.4)次vs(6.9±1.7)次,P<0.001]、切口愈合等级[例,甲/乙,(50/1)vs(44/7),P=0.027]、住院时间[(18.3±5.9)d vs(21.7±4.3)d,P<0.001]显著优于常规组。两组完全负重活动时间比较差异无统计学意义(P>0.05)。术后随时间推移,两组踝背伸-跖屈ROM、VAS评分及AOFAS评分均显著改善(P<0.05),相同时间点,两组上述指标的的差异均无统计学意义(P>0.05)。影像方面,两组骨折复位质量的差异无统计学意义(P>0.05)。[结论]数字化骨科技术应用于后Pilon骨折内固定术中,有助于缩短手术时间和骨折愈合时间,促进下肢踝关节功能的恢复。[Objective]To investigate the clinical efficiency of digital planning(DP)open reduction and internal fixation(ORIF)of Pi-lon fractures.[Methods]A total of 102 patients who had Pilon fractures being treated surgically from May 2019 to May 2022 were randomlydivided into two groups.Of them,51 patients received ORIF based on DP to simulate fracture reduction before the real surgery,while other51 patients underwent the conventional ORIF.The perioperative period,follow-up and imaging data of the two groups were compared.[Re-sults]The DP group proved significantly superior to the conventional group in terms of operation time[(93.6±18.0)min vs(107.6±20.3)min,P<0.001],total incision length[(14.6±2.9)cm vs(17.2±3.4)cm,P<0.001],intraoperative blood loss[(72.6±19.4)ml vs(87.2±20.5)ml,P<0.001],intraoperative fluoroscopy times[(4.8±1.4)times vs(6.9±1.7)times,P<0.001],incision healing scale[A/B,(50/1)vs(44/7),P=0.027],and hospital stay[(18.3±5.9)days vs(21.7±4.3)days,P<0.001].However,there was no significant difference in the time to resume fullweight-bearing activities between the two groups(P>0.05).The ROM,VAS and AOFAS scores in both groups were significantly improvedover time postoperatively(P<0.05),which were not statistically significant between the two groups at any time points accordingly(P>0.05).As for imaging,there was no statistically significant difference in the quality of fracture reduction between the two groups(P>0.05).[Con-clusion]Preoperative digital planning for open reduction and internal fixation of Pilon fractures is helpful to shorten the operative time andfracture healing time,and promote the recovery of ankle joint function.

关 键 词：后Pilon骨折 数字化骨科技术 愈合时间 踝关节功能 

分 类 号：R683.42[医药卫生—骨科学]