四柱支撑钢板与桥接解剖钢板治疗Rüedi-Allgower Ⅲ型Pilon骨折的疗效比较

Comparison of clinical effect between bridge locking anatomical plate with supported plate based four column in type Ⅲ Rüedi-Allgower Pilon fracture

目的比较四柱支撑钢板与桥接解剖钢板治疗Rüedi-AllgowerⅢ型Pilon骨折的临床疗效。方法对52例接受治疗的Rüedi-AllgowerⅢ型Pilon患者按照不同固定方式分为观察组("四柱"支撑钢板,28例)和对照组(桥接解剖钢板,24例)。评估手术时间、失血量、引流量、愈合时间、完全负重时间、功能与疼痛评分等指标。结果两组患者手术时间、失血量、引流量相比,差异无统计学意义(t=0. 37,P>0. 05;t=0. 71,P>0. 05;t=0. 24,P>0. 05)。观察组完全负重时间、骨折愈合时间方面明显低于对照组,差异有统计学意义(t=1. 56,P<0. 05;t=2. 43,P<0. 05)。术后1个月,两组患者美国足踝外科协会(AOFAS)踝-后足评分系统评分和视觉模拟评分法(VAS)评分相比,差异无统计学意义(t=0. 67,P>0. 05;t=0. 46,P>0. 05)。术后3、6个月起,观察组患者AOFAS评分和VAS评分明显优于对照组,差异有统计学意义(P<0. 05)。两组患者在复位质量Burwell-Charnley评分方面、并发症方面无明显差异(P>0. 05)。结论四柱支撑钢板治疗Rüedi-AllgowerⅢ型Pilon骨折能够有效提高患者生活质量,值得临床广泛推广。

Objective To explore the clinical effect between bridge locking anatomical plate with supported plate based four column in type Ⅲ Rüedi-Allgower Pilon fracture. Methods Retrospective study was performed on the clinical data of type Ⅲ Rüedi-Allgower Pilon fracture undergoing surgery. Patients were divided into two groups according to internal fixation. Some parameters including operation time,blood loss,and drainage,healing time,full burden time,functional score and pain score were analyzed. Results There was no significant difference between the operation time,blood loss and drainage between the two groups(t = 0. 37,P>0. 05;t = 0. 71,P>0. 05;t = 0. 24,P>0. 05). The healing time and full burden time of experimental group was lower than control group significantly(t = 1. 56,P<0. 05;t = 2. 43,P<0. 05). For American Orthopaedic Food and Ankle Society(AOFAS) score and visual analogue score(VAS) in postoperative 1 month,there was no significant difference between the two groups. For AOFAS score and VAS score in experimental group was lower than control group after 3 months(P < 0. 05). There was no significant difference between two groups in reduction quality Burwell-Charnley score and complication between two groups. Conclusion Supported plate based four column could improve the life quality of patietns with Pilon fracture,which is worth to recommed in clinical application.