踝前区弧形切口联合MIPO疗法对Pilon骨折患者的影响

Effect of Arc Incision in Anterior Malleolus Combined with MIPO Therapy on Pilon Fracture Patients

目的:探讨踝前区弧形切口联合微创钢板固定(MIPO)(踝前切口+MIPO)疗法对Pilon骨折患者的影响。方法:选取2020年3月-2021年6月顺德和平外科医院就诊的54例Pilon骨折患者。按照投掷硬币法将其分为对照组和试验组,各27例。对照组采用切开内固定治疗,试验组采用踝前切口+MIPO疗法。比较两组术后3个月踝关节功能、骨折复位情况,术前、术后3个月踝穴情况,围手术期指标及并发症。结果:术后3个月,试验组踝关节功能优于对照组(P<0.05)。术后3个月,试验组骨折复位情况优于对照组(P<0.05)。术后3个月,试验组踝穴冠状位角度差、宽度差、矢状位角度差均小于对照组(P<0.05)。试验组手术时间及住院时间均短于对照组,术中出血量少于对照组(P<0.05)。试验组并发症发生率低于对照组(P<0.05)。结论:Pilon骨折患者应用踝前切口+MIPO可促进骨折复位及踝穴形态恢复,改善踝关节功能,促进早日康复出院,且可减少并发症发生,安全性好。

Objective:To explore the effect of arc incision in anterior malleolus combined with minimally invasive plate osteosynthesis(MIPO)(anterior incision+MIPO)on Pilon fracture.Method:A total of 54 patients with Pilon fracture attending to Shunde Heping Surgical Hospital from March 2020 to June 2021 were selected.According to the coin tossing method,they were divided into control group and experimental group,with 27 cases in each group.The control group was treated with incision and internal fixation,and the experimental group was treated with anterior ankle incision+MIPO therapy.The ankle joint function,fracture reduction condition 3 months after operation,ankle acupoints condition before and 3 months after operation,perioperative indexes and complications were compared between the two groups.Result:Three months after operation,the ankle joint function of the experimental group was better than that of the control group(P<0.05).Three months after operation,the fracture reduction condition of the experimental group was better than that of the control group(P<0.05).Three months after operation,the coronal position angle difference,width difference and sagittal position angle difference of ankle acupoints in the experimental group were smaller than those in the control group(P<0.05).The operation time and hospital stay of the experimental group were shorter than those of the control group,and the amount of intraoperative bleeding was less than that of the control group(P<0.05).The incidence of complications in the experimental group was lower than that in the control group(P<0.05).Conclusion:The application of anterior incision+MIPO therapy in Pilon fracture patients can promote fracture reduction and ankle point shape recovery,improve ankle function,promote early recovery and discharge,and reduce complications,with good safety.