影响高能量Pilon骨折分步延期治疗效果的因素分析

目的探讨影响高能量Pilon骨折分步延期治疗效果的因素。方法2010年2月至2015年5月采用分步延期治疗的高能量Pilon骨折患者21例。治疗效果按Mazur踝关节功能评分标准进行判定，采用有序多分类logistic回归分析，对可能影响最终治疗效果的因素，如性别、年龄、骨折分型、内固定方式和软组织损伤评分等进行分析。结果2l例患者最终疗效的踝关节功能评分为优14例、良4例、可2例、差1例，整体优良率为86％。结论高能量Pilon骨折的手术疗效和最终恢复效果与患者的年龄、性别及内固定方式无关（P〉O．05），与骨折分型和软组织损伤评分密切相关（P〈O．05），其中Ⅲ型较Ⅱ型骨折的恢复效果差，而无论是开放性或闭合性Pilon骨折其软组织损伤评分越低，患者恢复效果越好。

Objective To investigate the effect of high energy Pilon step delay factors of treatment of bone fractures. Methods From February 2010 to May 2015 ,high energy Pilon two-stage delayed treatment of fractures was used in patients with 21 cases. The treatment effect according to Mazur ankle joint function scoring standard of judgment, the ordinal classification logistic regression analysis, was likely to affect the final treatment effect factors. Such as gender, age, type of fracture, internal fixation and soft tissue injury score were analyzed. Results 21 cases of patients with ankle joint ftmction score after the treatment was excellent in 14 cases, good in 4 cases, 2 cases, poor in 1 cases, the excellent rate was 86%. Conclusion Curative effect of high energy Pilon fractures and age the final recovery effect and patients, regardless of gender and internal fixations （ P〉0.05 ） , and is closely related to fracture and soft tissue injury score （ P〈0.05 ） , which is of type III type fracture recovery effect The lower score of soft tissue injury in both open and closed Pilon fractures, the better the recovery effect.