探讨经改良的后内侧入路联合支撑技术对后pilon骨折的疗效

Explore the Effect of Modified Posteromedial Approach Combined with Bracing Technique on Posterior Pilon Fracture

目的探究后pilon骨折采用经改良的后内侧入路联合支撑技术治疗的临床疗效。方法选取该院2017年1月—2019年1月收治的82例合并关节面塌陷的后pilon骨折患者为研究对象,所有患者均采用经改良的后内侧入路联合支撑技术治疗,分析患者的手术治疗效果、术后并发症发生情况。结果患者手术切口均Ⅰ期愈合,骨折愈合时间为3~6个月,平均愈合时间为(3.65±0.28)个月,骨折愈合优良率为95.12%;患者术后VAS评分为(1.08±0.28)分,低于术前;AOFAS评分为(95.26±2.28)分,高于术前,差异有统计学意义(t=42.909、82.407,P<0.05);所有患者均未出现感染、内固定物断裂、松动等情况出现,1例患者因术后行功能锻炼的时间过早,后内侧手术切口愈合延迟,2周换药后愈合,1例有轻微胫神经麻痹症状出现,给予其甲钴胺片口服后,症状得以缓解。结论后pilon骨折采用经改良的后内侧入路联合支撑技术治疗的临床疗效显著。

Objective To explore the clinical effect of modified posterior medial approach combined with support technology for posterior pilon fractures.Methods A total of 82 patients with posterior pilon fractures with articular surface collapse treated in the hospital from January 2017 to January 2019 were selected as the research object.All patients were treated with a modified posteromedial approach combined with support technology to analyze the patients'surgery treatment effect and postoperative complications.Results All the surgical incisions healed in I stage,the fracture healing time was 3-6 months,the average healing time was(3.65±0.28)months,and the excellent rate of fracture healing was 95.12%;the postoperative VAS score was(1.08±0.28)points,lower than preoperative,AOFAS score was(95.26±2.28)points,higher than preoperative,the difference was statistically significant(t=42.909,82.407,P<0.05);all patients did not have infection,internal fixation fracture,loosening,etc.,1 patient had a postoperative functional exercise prematurely,delayed healing of the posterior medial surgical incision,and healed after 2 weeks of dressing change.1 patient had mild tibial nerve palsy symptoms,and the symptoms were relieved after oral administration of mecobalamin tablets.Conclusion The clinical effect of posterior pilon fracture treated with modified posteromedial approach combined with bracing technique is significant.