锁定加压钢板与解剖钢板内固定修复Pilon骨折术后骨折愈合以及踝关节功能的比较

Comparative Anatomical Locking Compression Plate Fixation Pilon Fracture Surgery to Repair Ankle Fracture Healing and Inner Steel

目的:探讨锁定加压钢板与解剖钢板内固定修复Pilon骨折术后骨折复位、愈合以及踝关节功能的比较。方法:2013年1月至2016年1月期间,我院手术治疗闭合Ruedi-Allgower II、III型骨折患者80例,随机分为两组,各40例。其中一组选用锁定加压钢板固定,列为锁定板组;另一组采用解剖钢板固定,列为解剖板组。观察两组患者术后骨折复位以愈合的情况和术后3月、6月、12月的踝关节功能恢复情况。结果:两组患者骨折复位和愈合情况的比较:两组患者Burwell Chamley评分中解剖复位、复位可、复位差的患者相比较,差异均无统计学意义(P>0.05)。骨折愈合时间的比较,锁定板组愈合时间平均为(7.98±2.31)周,解剖板组平均为(14.33±3.21)周,相比较差异有统计学意义(P<0.05)。两组患者踝关节Tornetta评分的比较:术后3个月对患者行踝关节Tornetta评分,锁定板组患者优、良、中、差的患者分别占50.00%、32.50%、7.50%和10.00%,解剖板组患者分别为27.50%、45.00%、15.00%和12.5%,差异有统计学意义(P<0.05)。术后6个月对患者行踝关节Tornetta评分,锁定板组患者优、良、中、差的患者分别占62.50%、20.00%、10.00%和7.50%,解剖板组患者分别为45.00%、25.00%、20.00%和10.0%,比较差异有统计学意义(P<0.05)。术后3个月对患者行踝关节Tornetta评分,锁定板组患者优、良、中、差的患者分别占82.50%、10.00%、5.00%和2.50%,解剖板组患者分别为77.50%、12.50%、7.50%和7.50%,比较差异无统计学意义(P>0.05)。结论:两种手术方式中对于骨折的复位差异不大,但是使用锁定加压板更加利于骨折的愈合,可以缩短骨折愈合的时间,同时有利于术后踝关节功能的恢复。

Objective：To investigate the locking compression plate fixation with anatomic steel plate Pilon fracture surgery to repair fractures, ankle heal and compare functions.Methods：From January 2010 to January 2014, our hospital surgery closure Ruedi-Allgower II, III patients with fractures of80 cases were randomly divided into two groups, each of 40 cases. One group selection locking compression plate fixation, as the locking plate group; another group using anatomical platefixation, as anatomic plate group. Postoperative fractures were observed in the case and postoperative healing in March, June,December ankle function recovery.Results： The two groups of patients and healing fractures of comparison： the two groups Burwell Chamley score anatomically, can reset, reset the poor patients compared to no significant difference（P〉0.05）. Comparison of fracture healing time, the locking plate group, the average healing time was（7.98±2.31） weeks, an average of anatomical plate group（14.33±3.21） weeks, there was significant difference compared（P〈0.05）. Tornetta ankle were compared scores： after 3 months underwent ankle Tornetta score, locking plate group gifted patient, good, fair, poor patients accounted for50.00%, respectively, 32.50%, 7.50% and 10.00%, anatomic plate group of patients was 27.50%, 45.00%, 15.00% and12.5%, the difference was statistically significant（P〈0.05）. After 6 months underwent ankle Tornetta rates, the difference was statistically significant（P〈0.05）. After 3 months underwent ankle Tornetta rates, the difference was not statistically significant（P〉0.05）. Conclusion： The two surgical ways to reset the fracture little difference, but the use of locking compression plate is more conducive to fracture healing, fracture healing time can be shortened, while facilitating recovery after ankle joint function.