34例合并腓骨下段骨折的闭合性PILON骨折的手术治疗体会
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摘要
目的总结合并腓骨下段骨折的闭合性PILON骨折的手术治疗经验。方法 34例合并腓骨下段骨折的闭合性PILON骨折患者分别应用胫骨远端前外侧"L"型锁定钢板(A组,n=14)或胫骨远端内侧解剖锁定钢板(B组,n=20)内固定手术,比较两组的疗效。结果两组骨折复位、骨折愈合时间、踝关节活动度、疗效差异无统计学意义(P>0.05)。结论采用胫骨远端前外侧"L"型锁定钢板或胫骨远端内侧解剖锁定钢板内固定均可有效治疗腓骨下段骨折的闭合性PILON骨折。
Objective To summarize the surgical experience of closed PILON fracture with distal fibular fracture.Methods Thirty-four patients with closed PILON and distal fibula fracture were treated with L-shaped locking plate on the anterolateral distal tibia(group A, n=14) or anatomic locking plate on the medial distal tibia(group B, n=20). Clinical efficacy was compared between two groups. Results There were no significant differences in fracture reduction and healing time,ankle activity, and clinical efficacy between two groups(P>0.05). Conclusion Internal fixation with L-shaped locking plate or anatomic locking plate of distal tibia is effective for closed PILON fracture with distal fibular fracture.
Objective To summarize the surgical experience of closed PILON fracture with distal fibular fracture.Methods Thirty-four patients with closed PILON and distal fibula fracture were treated with L-shaped locking plate on the anterolateral distal tibia(group A, n=14) or anatomic locking plate on the medial distal tibia(group B, n=20). Clinical efficacy was compared between two groups. Results There were no significant differences in fracture reduction and healing time,ankle activity, and clinical efficacy between two groups(P>0.05). Conclusion Internal fixation with L-shaped locking plate or anatomic locking plate of distal tibia is effective for closed PILON fracture with distal fibular fracture.
引文
[1]陈鹏,赵凯,计飞,等.单切口钢板支撑在PILON骨折临床运用[J].浙江创伤外科, 2017, 22(1):122-124.
[2]燕双喜,王群,丁少波,等.混合内固定治疗严重PILON骨折体会[J].浙江临床医学, 2017, 19(8):1491-1492.
[3]赵宛民,干阜生,王宏亮,等.微创治疗内外踝骨折伴Ⅰ、Ⅱ型PILON骨折的临床疗效[J].实用骨科杂志, 2016,22(7):637-640.
[4] MAZUR J M, SCHWARTZ E, SIMON S R. Ankle arthrodesis long-term follow-up with gait analysis[J]. J Bone Joint Surg Am,1979, 61(7):964-975.
[5]王立祚,华贤章,敖传西.“L”型锁定钢板治疗RUEDIALLGOWERⅡ、Ⅲ型PILON骨折[J].实用骨科杂志, 2016,22(8):737-739.
[6]祁雷,吴晗,李军,等. PILON骨折的诊断与治疗进展[J].局解手术学杂志, 2018, 27(1):73-77.
[7]周成洪,龙亨国,沈万祥,等.微创三柱固定治疗高能量损伤PILON骨折临床疗效分析[J].浙江创伤外科, 2017,22(4):726-727.
[8]聂海,吴永乐,吴涛.高能量PILON骨折治疗策略[J].创伤外科杂志, 2016, 18(5):317-320.
[9]薛文,管晓鹂,康忠仁,等.胫骨远端前外侧切口L-解剖锁定板治疗B3、C型PILON骨折[J].临床骨科杂志, 2016,19(3):352-354.
[10]王海波,商杰,王业华.两种方法治疗粉碎性PILON骨折疗效分析[J].临床骨科杂志, 2017, 20(2):84-88.
[11]沈武君,严帮吉,卢烨超.胫骨远端“L”型锁定钢板治疗复杂PILON骨折[J].浙江临床医学, 2018, 20(6):1110-1114.
[12]周成洪,龙亨国,沈万祥,等.微创三柱固定治疗高能量损伤PILON骨折临床疗效分析[J].浙江创伤外科, 2017,22(4):726-727.
[13]马明,姜文雄,林照静,等.“L”型锁定钢板加植骨微创治疗胫骨PILON骨折临床分析[J].创伤外科杂志, 2016(1):25-27.
[14]李飞,周道政.微创经皮钢板内固定术结合锁定加压钢板治疗PILON骨折的疗效观察[J].浙江临床医学, 2016,18(6):1033-1035.
[15]王臻.微创经皮钢板内固定术治疗AO-C3型PILON骨折的应用研究[J].浙江创伤外科, 2016, 21(1):54-55.
[16]吴浩俊,何艳霞,陈航,等.胫骨远端骨折经皮微创经皮钢板固定术的复位技巧及疗效观察[J].广东医科大学学报,2018, 36(1):90-94.
[17]王立祚,华贤章,敖传西.“L”型锁定钢板治疗RUEDIALLGOWERⅡ、Ⅲ型PILON骨折[J].实用骨科杂志, 2016,22(8):737-739.
[18]蒋锋,王力群.锁定加压接骨板治疗高处坠落致PILON骨折的疗效分析[J].实用骨科杂志, 2015, 21(9):852-856.
[19]戴冲华,孙骏,陈坤全,等.漂浮体位下RUEDIALLGOWERⅡ、Ⅲ型PILON骨折的治疗[J].创伤外科杂志,2018, 20(1):56-58.
[2]燕双喜,王群,丁少波,等.混合内固定治疗严重PILON骨折体会[J].浙江临床医学, 2017, 19(8):1491-1492.
[3]赵宛民,干阜生,王宏亮,等.微创治疗内外踝骨折伴Ⅰ、Ⅱ型PILON骨折的临床疗效[J].实用骨科杂志, 2016,22(7):637-640.
[4] MAZUR J M, SCHWARTZ E, SIMON S R. Ankle arthrodesis long-term follow-up with gait analysis[J]. J Bone Joint Surg Am,1979, 61(7):964-975.
[5]王立祚,华贤章,敖传西.“L”型锁定钢板治疗RUEDIALLGOWERⅡ、Ⅲ型PILON骨折[J].实用骨科杂志, 2016,22(8):737-739.
[6]祁雷,吴晗,李军,等. PILON骨折的诊断与治疗进展[J].局解手术学杂志, 2018, 27(1):73-77.
[7]周成洪,龙亨国,沈万祥,等.微创三柱固定治疗高能量损伤PILON骨折临床疗效分析[J].浙江创伤外科, 2017,22(4):726-727.
[8]聂海,吴永乐,吴涛.高能量PILON骨折治疗策略[J].创伤外科杂志, 2016, 18(5):317-320.
[9]薛文,管晓鹂,康忠仁,等.胫骨远端前外侧切口L-解剖锁定板治疗B3、C型PILON骨折[J].临床骨科杂志, 2016,19(3):352-354.
[10]王海波,商杰,王业华.两种方法治疗粉碎性PILON骨折疗效分析[J].临床骨科杂志, 2017, 20(2):84-88.
[11]沈武君,严帮吉,卢烨超.胫骨远端“L”型锁定钢板治疗复杂PILON骨折[J].浙江临床医学, 2018, 20(6):1110-1114.
[12]周成洪,龙亨国,沈万祥,等.微创三柱固定治疗高能量损伤PILON骨折临床疗效分析[J].浙江创伤外科, 2017,22(4):726-727.
[13]马明,姜文雄,林照静,等.“L”型锁定钢板加植骨微创治疗胫骨PILON骨折临床分析[J].创伤外科杂志, 2016(1):25-27.
[14]李飞,周道政.微创经皮钢板内固定术结合锁定加压钢板治疗PILON骨折的疗效观察[J].浙江临床医学, 2016,18(6):1033-1035.
[15]王臻.微创经皮钢板内固定术治疗AO-C3型PILON骨折的应用研究[J].浙江创伤外科, 2016, 21(1):54-55.
[16]吴浩俊,何艳霞,陈航,等.胫骨远端骨折经皮微创经皮钢板固定术的复位技巧及疗效观察[J].广东医科大学学报,2018, 36(1):90-94.
[17]王立祚,华贤章,敖传西.“L”型锁定钢板治疗RUEDIALLGOWERⅡ、Ⅲ型PILON骨折[J].实用骨科杂志, 2016,22(8):737-739.
[18]蒋锋,王力群.锁定加压接骨板治疗高处坠落致PILON骨折的疗效分析[J].实用骨科杂志, 2015, 21(9):852-856.
[19]戴冲华,孙骏,陈坤全,等.漂浮体位下RUEDIALLGOWERⅡ、Ⅲ型PILON骨折的治疗[J].创伤外科杂志,2018, 20(1):56-58.