延期切开复位内固定术治疗高能量Pilon骨折的临床分析

Clinical evaluation of delayed open reduction and internal fixation for high energy Pilon fracture

[目的]评价延期切开复位内固定术治疗Ⅱ、Ⅲ型Pilon骨折的疗效及并发症发生率。[方法]回顾分析42例Pilon骨折患者,依据受伤至手术的时程长短将其分为A组及B组,并对患者疼痛、肿胀,功能康复以及骨折愈合等情况进行观察记录。[结果]A、B组胫骨远端关节面解剖复位率分别为57.1%和42.9%(P>0.05);A组踝关节功能明显优于B组(P<0.05);轻度软组织损伤术后并发症发生率小于重度(P<0.05);A组重度软组织损伤患者术后并发症发生率小于B组(P<0.05)。[结论]分步延期切开复位内固定术治疗Pilon骨折能有效的减少局部并发症并获得较好的踝关节功能。

[Objective]This study was aimed to evaluate the therapeutic effect and complication of delayed open reduction and internal fixation in the management of type II and III distal tibial Pilon fractures.[Method]This text established clinic observational tables for 42 cases of open tibial and fibular fracture.All cases were divided into group A and B（each group had 21 cases）according to the length of time between injury and surgery.We observed pain,swelling,functional rehabilitation and other indicators.[Result]The rates of anatomical reduction of the articular surface were 57.1% in group A and 42.9% in group B（P〉0.05）.The function of suffering ankle joint of group A was superior to that of group B（P〈0.05）.There was significant difference in the incidence of postoperative complications between light and severe soft tissue injury（P〈0.05）.There was difference in the incidence of postoperative complications between two goups in patients with severe soft tissue injury（P〈0.05）.[Conclusion]The delayed open reduction and internal fixation treatment protocol for type II and III Pilon fracture has advantages of fewer complications and good function.