后内侧入路及后外侧入路治疗Pilon骨折的临床疗效分析-现代医学

后内侧入路及后外侧入路治疗Pilon骨折的临床疗效分析

单位：池州市人民医院骨一科, 安徽池州 247000

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.

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