锁定加压钢板与解剖钢板内固定治疗Pilon骨折临床疗效比较

Comparison on the clinical efficacy of locking compression plate and anatomical plate in the treatment of Pilon fracture

目的比较锁定加压钢板与解剖钢板内固定治疗Pilon骨折的临床疗效。方法选择2016年1月至2018年1月期间榆林市府谷县人民医院骨科收治的70例Pilon骨折患者为研究对象,根据随机数表法将患者分为对照组和观察组,每组35例,对照组予解剖钢板内固定治疗,观察组应用锁定加压钢板治疗。比较两组患者的手术时间、术中出血量、住院时间及骨折愈合时间。随访1年,比较两组患者的Tornetta评分、Lysholm评分、解剖复位情况以及并发症发生情况。结果观察组患者的手术时间、住院时间及骨折愈合时间分别为(44.5±12.1)min、(18.2±4.3)d、(16.2±3.1)周,均明显短于对照组的(57.2±10.7)min、(23.8±4.5)d、(19.0±4.7)周,差异均有统计学意义(P<0.05);两组患者术中出血量比较差异无统计学意义(P>0.05);术后随访1年,观察组患者Tornetta评分优良率为94.29%,明显高于对照组的80.00%,Lysholm评分为(83.4±6.4)分,明显高于对照组的(78.6±5.2)分,差异均有统计学意义(P<0.05);观察组患者的解剖复位率为65.71%,与对照组的62.86%比较差异无统计学意义(P>0.05);观察组患者随访期间并发症发生率为2.86%,明显低于对照组的14.29%,差异有统计学意义(P<0.05)。结论与解剖钢板比较,锁定加压钢板内固定治疗Pilon骨折具有固定可靠、术后恢复快、术后并发症发生率的优点,且对踝关节功能及下肢功能的恢复更有利。

Objective To compare the clinical effects locking compression plate and anatomical plate in the treatment of Pilon fracture.Methods Seventy patients with Pilon fracture treated in Department of Orthopaedics, Fugu County People's Hospital, from January 2016 to January 2018 were selected as the study subjects.They were divided into an observation group and a control group according to random number table method, with 35 cases in each group.The control group used anatomical plate for internal fixation, while the observation group applied locking compression plate. The operation time, intraoperative blood loss, length of hospital stay, and fracture healing time were compared between the two groups.During the follow-up of 1 year, the excellent and good rate of Tornetta score, anatomical reduction, and incidence of complications were compared between the two groups.Results The operation time, length of hospital stay, and fracture healing time in the observation group were (44.5±12.1) min,(18.2±4.3) d,(16.2±3.1) week respectively, which were significantly shorter than (57.2±10.7) min,(23.8±4.5) d,(19.0±4.7) weeks in the control group (P<0.05). There was no significant difference in intraoperative bleeding volume between the two groups (P>0.05).After 1 year of follow-up, the excellent and good rate of Tornetta score in the observation group was 94.29%, which was significantly higher than 80.00% in the control group.The Lysholm score was 83.4±6.4, which was significantly higher than 78.6±5.2 in the control group (P<0.05).The anatomical reduction rate of the observation group was 65.71%, which was similar with 62.86% in the control group (P>0.05).The incidence of complications in the observation group was 2.86%, which was significantly lower than 14.29% in the control group (P<0.05).Conclusion Compared with anatomical plate, locking compression plate internal fixation for Pilon fracture has the advantages of reliable fixation, quick recovery, and less complications, and is more beneficial to the recovery of ankle joint function and lower limb function.