闭合复位或联合有限切开复位配合外固定支架治疗胫骨远端爆裂骨折(Pilon骨折)的临床疗效

Clinical Efficacy of Closed Reduction or Limited Open Reduction Com⁃bined with External Fixator in the Treatment of Distal Tibia Burst Fracture(Pilon Fracture)

目的探究闭合复位或联合有限切开复位配合踝关节外固定支架治疗胫骨远端爆裂骨折(Pilon骨折)的临床疗效。方法方便抽取该院2017年1月—2021年3月收治的122例胫骨远端爆裂骨折患者,基于治疗差异分为两组,每组61例。对照组予切开复位接骨板内固定术,观察组则予闭合复位或联合有限切开复位配合踝关节外固定支架治疗。评估比对两组治疗优良率和并发症情况。结果观察组住院时间(14.97±2.88)d、下地时间(15.32±2.31)周及骨折愈合时间(3.46±0.52)个月短于对照组(18.12±3.36)d、(17.25±2.67)周、(4.32±0.78)个月,差异有统计学意义(t=5.559、4.269、7.165,P<0.05);观察组治疗优良率(85.52%)及并发症发生率(14.75%)与对照组(86.89%、14.75%)比较,差异无统计学意义(P>0.05)。结论治疗胫骨远端爆裂骨折实施闭合复位或联合有限切开复位配合踝关节外固定支架作为首期治疗能获得相同的效果,且手术操作难度小,术后指标更优,且并未增加相关并发症。

Objective To explore the clinical effect of closed reduction or limited open reduction combined with ankle external fixation in the treatment of distal tibial burst fracture(Pilon fracture).Methods A total of 122 patients with burst fracture of the distal tibia in admitted to the hospital from January 2017 to March 2021 were conveniently selected and divided into two groups based on treatment differences,61 cases in each group.The control group was treated with open reduction and internal fixation with bone plate,while the observation group was treated with closed reduction or combined with limited open reduction and external fixation of ankle joint.The excellent and good rates and complications of the two groups were evaluated and compared.Results The length of hospital stay(14.97±2.88)d,the time of going to the ground(15.32±2.31)weeks and the time of fracture healing(3.46±0.52)months in the ob⁃servation group were shorter than those in the control group(18.12±3.36)d,(17.25±2.67)weeks,(4.32±0.78)months,the difference was statistically significant(t=5.559,4.269,7.165,P<0.05);the excellent and good rate(85.52%)and the incidence of complications(14.75%)in the observation group were compared with the control group(86.89%,14.75%),the difference was not statistically significant(P>0.05).For the treatment of distal tibia burst fractures closed reduction or combined limited open reduction combined with external ankle fixation can achieve the same ef⁃fect as the initial treatment,and the operation is less difficult,the postoperative indicators are better,and there is no increase in related complications.Closed reduction or limited open reduction combined with external fixation of ankle joint as the first stage treatment for burst fracture of distal tibia can achieve the same effect than open reduc⁃tion and internal fixation with bone plate,and the operation is less difficult,the postoperative indicators are better,and the related complications are not increased.