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后内侧入路及后外侧入路治疗Pilon骨折的临床疗效分析
作者:丁伟  胡磊  周骏武 
单位:池州市人民医院 骨一科, 安徽 池州 247000
关键词:Pilon骨折 手术入路 后外侧 后内侧 踝关节功能 
分类号:R683
出版年·卷·期(页码):2019·47·第一期(34-37)
摘要:

目的:探讨后内侧入路及后外侧入路在Pilon骨折治疗中的应用价值。方法:选取50例行手术治疗的Pilon骨折患者作为研究对象,根据手术入路方式的不同分为两组,内侧组(25例)采用后内侧入路方式,外侧组(25例)采用后外侧入路方式。比较两组的骨折愈合时间、术中失血量、切口长度、踝关节功能恢复情况等。结果:在单一骨块Pilon骨折患者中,两组的切口长度、术中出血量、骨折愈合时间比较,差异无统计学意义(P>0.05),术后1年内侧组与外侧组的踝关节功能恢复优良率分别为87.50%和86.67%,差异无统计学意义(P>0.05)。在双骨块Pilon骨折患者中,内侧组的切口长度比外侧组更短,术中出血量比外侧组更少(均P<0.05),但两组的骨折愈合时间接近(P>0.05),术后1年的踝关节功能恢复优良率内侧组显著高于外侧组(P<0.05)。结论:在Pilon骨折的手术治疗中,后内侧入路与后外侧入路均是有效的入路方式,后内侧入路对后踝双骨块Pilon骨折的疗效更好。

Objective:To investigate the application value of posteromedial and posterolateral approaches in the treatment of Pilon fractures. Methods: Fifty cases of Pilon fracture patients who underwent surgery were divided into two groups according to the surgical approach. The inside group (n=25) was treated with posteromedial approach, and the outside group (n=25)was treated with posterolateral approach. The fracture healing time, intraoperative blood loss, incision length, and ankle function recovery were compared between two the groups. Results: In patients with a single bone Pilon fracture,there was no significant difference in incision length, intraoperative blood loss, and fracture healing time between the two groups (P>0.05). The good rate of ankle joint function recovery in the inside group and the outside group respectively were 87.50% and 86.67%, there was no significant difference(P>0.05). In patients with double bone Pilon fractures, the incision length of the inside group was shorter than that of the outside group, and the intraoperative blood loss was less (P<0.05), but the fracture healing time of the two groups was close (P>0.05). The excellent rate of ankle function recovery at 1 year postoperatively was significantly higher in the inside group than in the outside group (P<0.05). Conclusion: In the surgical treatment of Pilon fractures, the posterior medial approach and the posterolateral approach are all effective approaches, and the posterior medial approach is more effective in the posterior malleolus Pilon fracture.

参考文献:

[1] 魏世隽,蔡贤华,刘曦明,等.后内侧入路低切迹多向锁定接骨板内固定治疗累及内踝的胫骨后Pilon骨折[J].中国修复重建外科杂志,2014,28(5):558-561.
[2] ELSOE R,LARSEN P,PETRUSKEVICIUS J,et al.Complex tibial fractures are associated with lower social classes and predict early exit from employment and worse patient-reported QOL:a prospective observational study of 46 complex tibial fractures treated with a ring fixator[J].Strategies Trauma Limb Reconstr,2018,13(1):25-33.
[3] 吴一芃,徐永清,师继红,等.Rüedi-Allg werⅢ型Pilon骨折的手术治疗[J].中国修复重建外科杂志,2014,28(7):828-831.
[4] 吴建华.胫骨Pilon骨折采用有限切开锁定钢板内固定治疗的临床效果分析[J].实用医学杂志,2014,30(18):3027-3028.
[5] 张晓剑,钱学峰.微创经皮非锁定钢板联合MIPPO治疗A型胫骨远端骨折的效果[J].东南大学学报(医学版),2016,35(6):952-955.
[6] NIELSEN P J,GROSSMAN L S,SIEBLER J C,et al.Is it safe to prep the external fixator in situ during second-stage Pilon surgical treatment[J].J Orthop Trauma,2018,32(3):e102-e105.
[7] 胡翰生,陶玉平,虞堂云,等.高能量闭合性Pilon骨折的手术治疗[J].江苏医药,2014,40(21):2593-2595.
[8] 张熙明,陈枫文,廉凯.前侧及内侧双钢板联合固定治疗Rüedi-Allgower Ⅲ型Pilon骨折[J].生物骨科材料与临床研究,2018,15(1):69-70.
[9] 周稳,任冬,魏小玲.分步延期手术与早期切开复位内固定手术治疗高能量Pilon骨折对照研究[J].中国现代医学杂志,2014,24(21):73-76.
[10] 缪国平,陆圣华.MIPPO技术结合胫骨远端内侧锁定加压接骨板治疗胫骨远端骨折[J].江苏医药,2014,40(20):2476-2477.

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