分步延期手术与早期切开复位内固定手术治疗Pilon骨折疗效比较
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摘要
目的比较分步延期手术与早期切开复位内固定手术治疗Pilon骨折的疗效。方法将2012年8月—2013年8月本院骨科接受分步延期手术的Plion骨折患者60例纳入观察组,2011年8月—2012年7月接受早期切口复位内固定治疗的Plion骨折患者60例纳入对照组,比较2组患者的手术情况、骨折愈合情况及关节功能恢复情况。结果观察组患者手术时间(47.9±8.04)min,卧床时间(5.4±0.7)d,住院总时间(8.4±1.0)d,影像学完全愈合时间(116.7±15.2)d,完全负重下地时间(161.9±23.1)d,上述指标均优于对照组;观察组术中出血量及并发症发生率低于对照组;观察组患者的Baird踝关节评分均高于对照组。结论分步延期手术能够减小手术创伤,促进骨折愈合,预防并发症,改善踝关节功能,是治疗高能量Pilon骨折的理想方法。
Objective To compare the effects of fractional delay operation and early incision internal fixation operation in treating high energy Pilon fracture. Methods 120 Pilon fracture patients were divided into observation group and control group,and they were treated with fractional delay operation and early incision internal fixation operation respectively. Then operation conditions,fracture healing condition,joint function recovery were compared between two groups. Results In the observation group,the operation time was(47. 9 ± 8. 04)minutes,bed time was(5. 4 ± 0. 7) days,hospitalization time was(8. 4 ± 1. 0) days,radiological complete healing time was(116. 7 ± 15. 2) days and completely weight- bearing time was(161. 9 ± 23. 1) days,all the indexes mentioned above were significantly better than control group. Intraoperative bleeding volume,cases of traumatic arthritis,bone nonunion and ankle joint stiffness were less than control group. Baird ankle joint scores of observation group were higher than control group. Conclusion Fractional delay operation is an ideal method for treatment of high energy Pilon fracture,because it can promote healing,prevent complications and improve ankle joint function.
Objective To compare the effects of fractional delay operation and early incision internal fixation operation in treating high energy Pilon fracture. Methods 120 Pilon fracture patients were divided into observation group and control group,and they were treated with fractional delay operation and early incision internal fixation operation respectively. Then operation conditions,fracture healing condition,joint function recovery were compared between two groups. Results In the observation group,the operation time was(47. 9 ± 8. 04)minutes,bed time was(5. 4 ± 0. 7) days,hospitalization time was(8. 4 ± 1. 0) days,radiological complete healing time was(116. 7 ± 15. 2) days and completely weight- bearing time was(161. 9 ± 23. 1) days,all the indexes mentioned above were significantly better than control group. Intraoperative bleeding volume,cases of traumatic arthritis,bone nonunion and ankle joint stiffness were less than control group. Baird ankle joint scores of observation group were higher than control group. Conclusion Fractional delay operation is an ideal method for treatment of high energy Pilon fracture,because it can promote healing,prevent complications and improve ankle joint function.
引文
[1]赵志雄.Pilon骨折32例治疗方法和疗效分析[J].实用临床医药杂志,2011,15(17):161.
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[7]涂应兵,杨德菊,李志华,等.分步延期有限内固定结合外固定架治疗Ⅲ型Pilon骨折[J].实用骨科杂志,2013,19(2):175.
[8]Davidovtch R I,Elkataran R,Romo S,et al.Open reduction with internal fixaton verus limited internal fixation and external fixation for high grade pilon fractures[J].Foot Ankle Int,2011,32(10):955.
[9]黄洪,储辉.影响胫骨Pilon骨折疗效的相关因素分析[J].中国矫形外科杂志,2012,20(6):490.
[10]陶建军,施俊,彭明铭,等.延期手术治疗闭合性胫骨Pilon骨折合并腓骨下段骨折31例[J].湖北医药学院学报,2011,30(4):416.
[11]Aydin A.Atmaca H.Muezzinoglu U S.Anterior knee dislocation with ipsilateral open tibial shaft fracture:a 5-year clinical follow-up of a professional athlete[J].Musculoskelet Surg,2013,97(2):165.
[12]刘红光,吴小涛,张文捷,等.延期有限切开复位内结合外固定支架治疗严重胫骨Pilon骨折[J].实用临床医药杂志,2010,14(23):35.
[2]Schulz A P,Fuchs S,Simon L,et al.Severe fracture of the tibial pilon:results with a multieirectional self-locking osteosynthesis plate utilizing a two-stage procedure[J].Eur J Trauma Emerg Surg,2008,34(4):391.
[3]Ruedi T P,Allgower M.The operative treratment of intraaticular fracture of the lower end of the tibia[J].Clin Orthopo Relat Res,1979,(138):105.
[4]李纯璞,郭冬梅,孙磊,等.延期切开复位内固定术治疗高能量Pilon骨折的临床分析[J].中国矫形外科杂志,2011,19(16):1336.
[5]段戡,姚弘毅,袁长深,等.Pilon骨折手术治疗的国外进展[J].中国矫形外科杂志,2008,16(22):1730.
[6]Barei D P,Nork S E,Mills W J,et al.Complications associated with internal fixation of high-energy bicondylar tibial plateau fractures utilizing a two-incision technique[J].J Orthop Trauma,2004,18(10):649.
[7]涂应兵,杨德菊,李志华,等.分步延期有限内固定结合外固定架治疗Ⅲ型Pilon骨折[J].实用骨科杂志,2013,19(2):175.
[8]Davidovtch R I,Elkataran R,Romo S,et al.Open reduction with internal fixaton verus limited internal fixation and external fixation for high grade pilon fractures[J].Foot Ankle Int,2011,32(10):955.
[9]黄洪,储辉.影响胫骨Pilon骨折疗效的相关因素分析[J].中国矫形外科杂志,2012,20(6):490.
[10]陶建军,施俊,彭明铭,等.延期手术治疗闭合性胫骨Pilon骨折合并腓骨下段骨折31例[J].湖北医药学院学报,2011,30(4):416.
[11]Aydin A.Atmaca H.Muezzinoglu U S.Anterior knee dislocation with ipsilateral open tibial shaft fracture:a 5-year clinical follow-up of a professional athlete[J].Musculoskelet Surg,2013,97(2):165.
[12]刘红光,吴小涛,张文捷,等.延期有限切开复位内结合外固定支架治疗严重胫骨Pilon骨折[J].实用临床医药杂志,2010,14(23):35.