LCP治疗Pilon骨折的回顾性临床研究

Retrospective Clinical Study of Treatment with Locking Compress Plate(LCP)in Senile Patients with Pilon Fractures

目的：通过比较锁定加压钢板（LCP）与胫骨远端端解剖板治疗Ruedi AllgowerⅡ型、Ⅲ型Pilon骨折，回顾性评价锁定加压钢板（LCP）的临床效果。方法：2008年9月-2011年9月对86例Ruedi AllgowerⅡ型、Ⅲ型Pilon骨折患者资料回顾性分析，根据内固定方式分为两组，LCP组（A组）46例和胫骨远端端解剖板组（B组）40例，对两组患者的手术时间、骨折愈合时间、骨折愈合率、踝关节功能优良率及术后并发症等进行比较分析。结果：A组和B组平均手术时间分别为（100.6±12.3）min、（115.2±15.6）min，比较差异有统计学意义（P〈0.05）。两组患者均获得随访，随访时间12~21个月，平均18个月，骨折全部愈合，A组骨折愈合时间为10~12周，B组为12~18.5周，比较差异有统计学意义（P〈0.05）。按Mazur评分标准评定：A组：优38例，良6例，差2例；B组优20例，良12例，差8例，两组比较差异有统计学意义（P〈0.05）。A组发生并发症4例，发生率为8.6%，其中切口感染1例、皮肤坏死2例，关节僵硬1例；B组9例，发生率为22.5%，其中切口感染1例、皮肤坏死2例，关节僵硬2例，内固定物失效3例，骨折不愈合1例，两组并发症发生率比较差异有统计学意义（P〈0.05）。结论：采用锁定加压钢板（LCP）治疗复杂Pilon骨折，创伤小，固定可靠，骨折愈合快，术后恢复快，并发症少，能获得满意疗效。

Objective：To retrospectively analyze the results of treatment with Locking compress plate（LCP）for Ruedi AllgowerⅡ、ⅢPilon Fracture in comparison with distal tibia anatomical plate.Method：86 cases of patients with Ruedi AllgowerⅡandⅢwith Locking compress plate（LCP） were analyzed retrospectively from September 2008 to September 2011 and the treatment effect was observed.46 patients（group A）were treated with LCP,40 patients（group B）were treated with distal tibia anatomical plate.The clinical outcomes were compared between the two methods,including operation time,fracture healing time,rate of fracture healing,Mazur score and complications.Result：The operation time averaged（100.6±12.3）min in group A,（115.2±15.6）min in group B,there was statistically significant difference between the groups（P〈0.05）.All cases were followed-up（mean 18 months,range 12-21 months）.Fracture healing time of group A was 10-12 weeks,group B was 12-18.5 weeks（P〈0.05）.By Mazur scoring system, in group A find 38 excellent cases,6 good ones,2 fair one found excellent in 38 cases,good in 6 cases,poor in 2 cases,with 95.7%in excellent and good rate,and in group B found excellent in 20 cases,good in 12 cases,poor in 8 cases,with 80%in excellent and good rate,there was statistically significant difference between the groups（P〈0.05）.After operation,4 complications occurred in group A（8.7%）.1 case of incision infection,2 cases of skin and soft tissue necrosises,1 case of anchylosis.And 9 complications in group B（22.5%）.1 case of incision infection,2 cases of skin and soft tissue necrosises,2 cases of anchylosis,3 cases of fixation failure,1 case Fracture disunion,the omplications occurred was statistically significant difference between the groups（P〈0.05）.Conclusion：It is an ideal method to treat unstable Ruedi AllgowerⅡ、ⅢPilon Fracture with Locking compress plate（LCP）.The procedure is convenient and the fixation is stable,leading to fast fracture healing,good reovery and limited complications.And can gain satisfied results.