非跨关节外固定支架治疗严重Pilon骨折的临床研究

Clinical study of non-cross-articular external fixation for the treatment of severe Pilon fracture

目的Pilon骨折作为高能量损伤,治疗上极具挑战性。本研究评估单纯运用非跨关节外固定支架治疗Pilon骨折的有效性和安全性。方法回顾性分析本院收治的严重Pilon骨折患者的临床资料;采用非跨关节外固定支架治疗骨折,注意局部软组织保护,早期进行踝关节功能恢复锻炼。结果共纳入38例患者,平均年龄39岁;平均随访18个月(3~24个月)。致伤因素包括高坠伤,车祸伤和重物砸伤。伤后到接受手术平均时间8.5 d;平均手术时长110 min,平均出血130ml,平均住院13 d。术后24周时全部临床愈合。AOFAS踝关节评分显示踝关节总体优良率92%。结论非跨关节外固定支架治疗严重pilon骨折,术后皮肤软组织相关并发症低,骨折愈合速度快,愈合率高;远期随访显示踝关节功能优良率高。今后有必要开展更高质量的临床研究来验证其有效性和安全性。

Objective Pilon fractures are highly challenging for treatment as high-energy injuries.This study evaluated the efficacy and safety of a non-cross-articular external fixation in the treatment of Pilon fractures.Methods The clinical data of patients with severe Pilon fractures admitted to our hospital were retrospectively analyzed.Non-cross-articular external fixation was used to treat fractures,local soft tissue protection was observed,and ankle function recovery was performed early.Results A total of 38 patients were enrolled,with an average age of 39 years;the average follow-up period was 18 months(3-24 months).Injury factors include high falls,car accidents and heavy injuries.The average time from injury to surgery was 8.5 days;the average operation time was 110 minutes,the average bleeding was 130 ml,and the average hospital stay was 13 days.All clinically healed at 24 weeks postoperatively.The AOFAS ankle score showed an overall excellent rate of 92%of the ankle joint.Conclusion Non-cross-articular external fixation for the treatment of severe Pilon fractures,low postoperative complications associated with skin and soft tissue,rapid fracture healing and high healing rate;long-term follow-up showed an excellent rate of ankle joint function.In the future,it is necessary to conduct higher quality clinical studies to verify its effectiveness and safety.