摘要
目的观察并比较不同入路切开复位内固定治疗KlammerⅡ、Ⅲ型后Pilon骨折的临床疗效。方法将浙江省武义县第一人民医院2017年8月-2019年8月收治的86例KlammerⅡ、Ⅲ型后Pilon骨折患者按随机数字表法分为后外侧入路组和联合入路组,每组43例。后外侧入路组采用后外侧入路切开复位内固定治疗,联合入路组采用后外侧联合后内侧入路切开复位内固定治疗,比较两组手术相关指标、愈合情况、术后1个月和术后3个月疼痛程度、踝关节功能变化及并发症发生情况。结果联合入路组手术时间较后外侧入路组长,住院时间、骨折愈合时间较后外侧入路组短,差异具有统计学意义(P<0.05);与术后1个月相比,术后3个月两组VAS评分均下降,AOFAS评分均上升,且联合入路组VAS评分较后外侧入路低,AOFAS评分较后外侧入路组高,差异具有统计学意义(P<0.05);联合入路组术中出血量、并发症发生率与后外侧入路相比,差异无统计学意义(P>0.05)。结论采用后外侧联合后内侧入路切开复位内固定治疗KlammerⅡ、Ⅲ型后Pilon骨折,效果显著,可有效促进骨折愈合,改善踝关节功能,且不增加并发症,减轻患者痛苦,改善预后,值得推广。
Objective To observe and compare the clinical effects of open reduction and internal fixation with different combined approaches in the treatment of Klammer typeⅡandⅢPosterior Pilon fracture.Methods A total of 86 patients with Klammer typeⅡandⅢpost Pilon fractures admitted to the First People’s Hospital of Wuyi County,Zhejiang Province between August 2017 and August 2019 were divided into poster lateral approach group and combined approach according to the random number table.Group,43 cases in each group.The poster lateral approach group was treated with open reduction and internal fixation through the poster lateral approach,and the combined approach group was treated with open reduction and internal fixation through the poster lateral and poster medial approach.The two groups were compared with surgery-re-lated indicators,healing conditions,and 1 after surgery.Month and 3 months pain degree,changes in ankle joint function and complications.Results The operation time of the combined approach group was longer than that of the poster lateral approach group,and the hospitalization time and fracture healing time were shorter than those of the poster lateral approach group.The difference was statistically significant(P<0.05);compared with 1 month after surgery,surgery In the last 3 months,the VAS scores of the two groups decreased,and the AOFAS scores increased.The VAS score of the combined approach group was lower than that of the poster lateral approach,and the AOFAS score was higher than that of the poster lateral approach group.The difference was statistically significant(P<0.05);Compared with the poster lateral approach,the complication rate of the combined approach group was not statistically different(P>0.05).Conclusion The use of poster lateral combined poster medial approach open reduction and internal fixation for the treatment of Klammer typeⅡandⅢPosterior Pilon fracture is effective.It can effectively promote fracture healing,improve ankle function without increasing complications,alleviate patient suffering,and improve prognosis,It is worth promoting.
作者
涂旭辉
TU Xuhui(Wuyi first people's Hospital,Wuyi 321200,China)
出处
《浙江实用医学》
2021年第3期198-201,共4页
Zhejiang Practical Medicine
关键词
后Pilon骨折
内固定
后外侧入路
前内侧入路
Poster lateral approach
Anteromedial approach
Posterior Pilon fracture
Internal fixation
