经皮微创解剖锁定板在Pilon骨折中的临床应用

Clinical Application of Minimally Invasive Percutaneous Anatomical LocKing Plate in Pilon Fractures

目的:探讨经皮微创解剖锁定板治疗Pilon骨折的手术时机、手术优势和手术要求。方法:选取35例Pilon骨折先行跟骨牵引,2期经皮微创解剖锁定板内固定为治疗组,随机选取同时期切开复位内侧解剖锁定板内固定为对照组,分析2组手术时间、术中出血量、住院时间及术后并发症,术后疗效按Tornetta判断标准进行比较。结果:2组在手术时间、住院时间、术中出血量及骨折愈合时间、远期功能疗效满意度方面差异均有显著性统计学意义。结论:经皮微创与切开复位内侧解剖锁定板治疗Pilon骨折均取得满意的术后疗效,但采用经皮微创闭合复位的方法治疗Pilon骨折创伤小、减少术后并发症的发生,有利于骨折愈合,有利于患者的早日康复,亦可节省费用。

Objective ：To investigate the surgical timing, advantages and requirements in treatment of Pilon fractures with minimally invasive percutaneous anatomic locking plate. Methods：Initially, 35 patients with Pilon fracture were enrolled to have calcaneal traction. In the second phase, the patients who received internal fixation with minimally invasive percutaneous anatomic locking plate were enrolled in the treatment group while the patients who received the open reduction and internal fixation with medial anatomic locking plate were randomly enrolled in the control group. The operative time, intra - operative bleeding, length of stay, and post - operative complications were analyzed between two groups and the post - operative effects were compared according to Tornetta criteria. Results： There were statis- tically significant differences in the operative time, length of stay, intra -operative bleeding, fracture healing time, long -term func- tions, and efficacy satisfaction. Conclusion：Minimally invasive surgery combined with open reduction and internal fixation with medial anatomic locking plate in treatment of Pilon fractures achieved satisfactory postoperative results, but closed reduction with minimally inva- sive percutaneous treatment of Pilon fracture would bring few traumas, reduce the incidence of postoperative complications, be conducive to fracture healing and early recovery of the patient, and save costs.