胫骨远端前内侧入路治疗Pilon骨折的手术效果及并发症情况分析

Analysis of Surgical Effect and Complications of Distal Tibia Anterior Medial Approach for the Treatment of Pilon Fractures

目的探讨胫骨远端前内侧入路手术治疗Pilon骨折的手术手术效果及并发症情况。方法选取我院2013年2月至2018年2月拟实施手术治疗的Pilon骨折患者58例,采用随机数字表法分为A组、B组各29例,A组采用胫骨远端前内侧入路手术治疗、B组采用胫骨远端内侧入路治疗;对比两组患者的手术时间、出血量、骨折愈合时间、复位效果、术后踝关节功能及各项手术并发症。结果A组患者的手术时间、出血量与B组比较差异无统计学意义(P>0.05),A组患者的骨折愈合是时间低于B组,差异有统计学意义(P<0.05);A组患者的解剖复位率79.31%、B组患者的解剖复位率51.72%,A组患者的骨折复位效果优于B组,差异有统计学意义(P<0.05);术后3个月,A组患者的踝关节功能与B组比较,差异无统计学意义(P>0.05);A组患者的手术并发症率6.90%与B组患者的17.24%比较,差异无统计学意义(P>0.05)。结论胫骨远端前内侧入路手术治疗Pilon骨折较胫骨远端内侧入路具有更好的手术复位效果,有利于缩短患者骨折愈合时间,两种入路的并发症情况无明显差异。

Objective To investigate the surgical effect and complications of distal tibia anterior medial approach for the treatment of Pilon fractures.Methods A total of 58 patients with Pilon fractures who underwent surgical treatment from February 2013 to February 2018 in our hospital were enrolled.The patients were randomly divided into group A and group B,29 patients,respectively. Group A was treated with anterior medial approach and group B was treated with medial approach for the treatment of distal tibia.The operation time,blood loss,fracture healing time,reduction effect,postoperative ankle joint function and various surgical complications were compared between the two groups.Results There was no significant difference in the operation time and bleeding loss between group A and group B( P>0.05).The fracture healing time of group A was lower than that of group B( P< 0.05).The anatomical reduction rate of the patients in the group A was 79.31%,and group B was 51.72%.The fracture reduction effect of the patients in group A was better than that in group B( P<0.05).3 months after surgery,there was no significant difference in the ankle function between group A and B( P> 0.05).The operative complication rate of the patients in group A was 6.90%,compared with 17.24% in group B,the difference was not statistically significant( P>0.05).Conclusion The anterior medial approach for the treatment of Pilon fractures in distal tibia,with the advantage to shorten the fracture healing time of patients, has a better surgical reduction than the medial approach.There is no significant difference in the complications of the two approaches.