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骨盆漂浮体位后外联合后内侧入路治疗后Pilon骨折24例 被引量:1

24 Cases of Posterior Pilon Fracture Treated by Posterolateral and Posteromedial Approach with Pelvic Floating Position
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摘要 目的:评估在骨盆漂浮体位下通过踝关节后外联合后内侧入路治疗后Pilon骨折的临床疗效。方法:选取2016年6月至2019年6月收治的后Pilon骨折患者24例,采用骨盆漂浮体位从踝关节后外联合后内侧入路进行钢板螺钉内固定治疗。观察和记录手术时间、术中出血量、术后切口并发症、骨折临床愈合时间及末次随访美国足踝外科协会(AOFAS)踝与后足功能评分。结果:24例患者均得到随访,随访时间9~18个月,平均13.3个月;手术时间70~120min,平均95min;术中出血量20~150mL,平均60mL;术后切口均未发生感染、皮缘坏死,均为一期愈合;骨折临床愈合时间10~20周,平均14周;末次随访AOFAS踝与后足评分优16例,良5例,中3例,差0例。结论:后Pilon骨折手术治疗时采用骨盆漂浮体位,通过踝关节后外联合后内侧入路手术暴露清晰,骨折复位和钢板螺钉放置简便,固定牢固,临床疗效满意。 Objective:To evaluate the clinical effect of pelvic floating position via posterolateral and posteromedial approach in treating posterior Pilon fracture treated.Methods:24patients with posterior Pilon fracture admitted from June 2016to June 2019 were selected and treated with plate and screw internal fixation through posterolateral and posteromedial approach of ankle joint by pelvic floating position.The operation time,intraoperative blood loss,postoperative incision complications,clinical fracture healing time and the American Orthopaedic Foot Ankle Society(AOFAS)ankle-hindfoot score at the last follow-up were observed and recorded.Results:All the 24patients were followed up for 9-18months(13.3months on average).The operation time was 70-120min(95min on average).Intraoperative blood loss was 20-150mL(60mL on average).No infection or wound edge necrosis occurred in all the incisions,and all the cases had primary healing.The clinical fracture healing time was 10-20weeks(14weeks on average).AOFAS ankle and hindfoot scores at the last follow-up showed that 16cases were excellent,5cases were good,3cases were medium,and 0cases were poor.Conclusion:Posterior Pilon fracture treated with pelvic floating position through the posterolateral and posteromedial approach can achieve satisfactory clinical effect,which is well for operation exposure as well as fracture reduction,and get the internal fixation placement simple and firm.
作者 陈王 余添赐 李铭雄 CHEN Wang;YU Tianci;LI Mingxiong(Department of Lower Limbs,Quanzhou Orthopedic-Traumatological Hospital,Quanzhou 362000,Fujian China.)
出处 《中国中医骨伤科杂志》 CAS 2021年第1期76-79,共4页 Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词 漂浮体位 手术入路 后Pilon骨折 floating position surgical approach posterior Pilon fracture
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