一期闭合复位外固定序贯二期内固定治疗C3型Pilon骨折的临床效果

Clinical effect of phaseⅠclosed reduction and external fixation sequential phaseⅡinternal fixation in the treatment of C3 Pilon fracture

目的探究一期闭合复位外固定序贯二期内固定治疗C3型Pilon骨折的临床效果。方法选取2019年1月至2021年6月中国人民解放军联勤保障部队第九〇四医院常州医疗区C3型Pilon骨折患者82例,按照随机数字表法将其分为对照组(常规切开复位内固定)、观察组(一期闭合复位外固定序贯二期内固定),每组41例。比较两组围手术期指标、治疗效果。比较两组术前及术后3个月的踝关节功能、视觉模拟评分法(VAS)及生活质量量表评分。记录两组并发症发生情况。结果观察组术中出血量低于对照组,骨折愈合时间短于对照组,治疗效果优于对照组(P<0.05)。术后3个月,两组踝关节功能、生活质量量表评分均高于术前,且观察组高于对照组(P<0.05)。术后3个月,两组VAS评分均低于术前,且观察组低于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论一期闭合复位外固定序贯二期内固定治疗C3型Pilon骨折能减少术中出血量、骨折愈合时间,改善踝关节功能,提高患者生活质量,且安全性高,值得临床推广。

Objective To explore the clinical effect of phaseⅠclosed reduction and external fixation sequential phaseⅡinternal fixation in the treatment of C3 Pilon fracture.Methods According to the random number table,82 patients with C3 Pilon fracture of 904th Hospital of Chinese PLA Joint Logistics Support Force from January 2019 to June 2021 were selected and divided into control group(conventional incision reduction internal fixation)and observation group(phaseⅠclosed reduction and external fixation sequential internal fixation),with 41 cases in each group.The perioperative indexes and therapeutic effects of the two groups were compared.Ankle function,visual analog scale(VAS),and quality of life questionnaire score were compared between the two groups before and three months after operation.The complications of the two groups were recorded.Results The amount of intraoperative blood loss in the observation group was lower than that in the control group,the fracture healing time was shorter than that in the control group,and the treatment effect was better than that in the control group(P<0.05).Three months after operation,ankle function and quality of life questionnaire scores in both groups were higher than those before operation,and the observation group was higher than the control group(P<0.05).Three months after operation,VAS scores in both groups were lower than those before operation,and the observation group was lower than the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion PhaseⅠclosed reduction and external fixation sequential phaseⅡinternal fixation in the treatment of C3 Pilon fracture can reduce intraoperative blood loss,fracture healing time,improve ankle joint function,and improve the quality of life of patients,with high safety and worthy of clinical promotion.