有限内固定结合外固定支架固定与切开复位内固定治疗胫骨Pilon骨折的疗效比较

The efficacy comparison of the operation methods for tibial pilon fracture between open reduction and internal fixation and limited internal fixation combined with external fixed support fixation

目的 比较两种不同方法治疗胫骨Pilon骨折的疗效.方法选择我院2006年1月～2009年12月76例胫骨Pilon骨折患者,通过影像检查,针对损伤情况制定不同的处理方法,33例有限内固定结合外固定支架固定的患者为结合组,43例采取切开复位内固定治疗的患者为内固定组,所有患者均随访6~36个月,比较两组患者踝关节症状与功能评分.结果结合组Muzur分值（83.49±3.81）分,优14例,良15例,优良率87.88%;内固定组Muzur分值（90.07±2.88）分,优24例,良16例,优良率93.02%,内固定组治疗效果及Muzur分值略高于结合组,但两组胫骨Pilon骨折患者疗效比较差异无显著性（P = 0.0753,0.0592）.结论 有限内固定结合外固定支架固定与切开复位内固定两种方法均有适应者,术前结合检查资料综合评估,选择合适的手术方法,术中严格按操作规程操作是提高治疗效果的关键.

Objective To compare the efficacy comparison of the operation methods for tibial pilon fracture between open reduction and internal fixation and limited internal fixed combined with external fixed support fixed. Methods A total of 76 cases＂ information with tibial pilon fracture were retrospectively analyzed, and different processing methods were developed according to the damage conditions, 33 cases in the bond group were treated by the limited internal fixed combined with external fixed support fixed treatment, 43 cases in the fixed group were treated by open reduction and internal fixation,all of the patients were followed up for 6 to 36 months,the favourable functional ankle symptoms of the two groups were compared. Results In the bond group （Muzur score （83.49 ＋ 3.81 ） ）.14 cases were optimal,15 cases were good, the probability was 87.88% ;in the fixed group （Muzur score （90.07＋2.88））,24 cases were optimal, 16 cases were good, the probability was 93.02%, effect of internal fixation treatment group and Muzur score were slightly higher than the combination group ,but the difference between the two groups＂ efficacy was no significant （P = 0.0753,0.0592）. Conclusion The open reduction and internal fixation method and the limited internal fixation com- bined with external fixed support fixation method both had the indications,we should combined with the control data to comprehensive evaluate,then choose the right operation methods,strict accordance with the operation procedures in the operation,those were the the keys to enhance the treatment effect.