Pilon骨折术后踝穴形态改变与踝关节功能关系分析

Analysis of the relationship between morphological changes of ankle mortise and ankle function after Pilon fracture surgery

目的 研究Pilon骨折术后踝穴形态改变与踝关节功能关系。方法 选择50例接受手术治疗的Pilon骨折患者,依据Mazur评分法对患者患侧的踝关节功能实施评分分组：优组（93~100分）29例,良组（87~92分）12例,可、差组（〈87分）9例。治疗后对比患者患侧和健侧的踝穴宽度和深度、冠状位角度及矢状位角度,各组踝穴在患侧和健侧的差值,并进一步进行各组组内比较分析。结果 患者患侧的踝穴宽度和深度、冠状位角度及矢状位角度均显著大于健侧（P均〈0.05）,但踝穴高度比较差异无统计学意义;3组在宽度差、深度差、冠状位角度差、矢状位角度差方面比较差异均有统计学意义（P均〈0.05）,但高度差比较差异无统计学意义;3组踝穴宽度和深度、冠状位角度及矢状位角度两两比较差异均有统计学意义（P均〈0.05）。结论 Pilon骨折术后踝穴形态变化可能对患者踝关节的功能恢复产生影响,值得重视。

Objective It is to explore the relation between morphological changes of ankle mortise and ankle function after Pilon fracture surgery. Methods 50 patients with Pilon fracture received surgical treatment were enrolled and grouped based on the scores of ankle function on the affected side using Mazur scoring system. There 29 cases in excellent group （93 - 100）, 12 cases in good group （87 -92） , and 9 cases in bad group（ 〈 87）. After the surgery, the ankle mortise function indicators on the affected and uninjured side were compared. The differences of the ankle mortise function indicators on the affected and un- injured side among different groups were also recorded, followed by intra-group comparative analysis. Results The width and depth of ankle mortise, coronal angle and sagittal angle on the affected side were all significantly greater than those on the un- injured side, and the differences were statistically significant （ All P 〈 0.05 ）, but there was no significant differences between the height of ankle mortise （ P 〉 0.05）. Significant differences existed in width difference, depth difference, coronal and sag- itta｜ angle difference among different groups （ All P 〈 0.05 ）, and no significant difference existed in height difference among different groups （P 〉 0.05）. The differences in ankle mortise width, depth, coronal and sagittal angle were found among dif- ferent groups （All P 〈 0.05）. Conclusion The morphological changes of ankle mortise after the Pilon fracture surgery might have impact on ankle function recovery, and it should be paid special attention.