筋膜切开减压联合负压封闭引流在闭合性Ruedi-Allgower Ⅱ~Ⅲ型pilon骨折治疗中的临床效果

Clinical curative effect of fasciotomy decompression combined with vacuum sealing drainage on closed type Rue⁃di-Allgower Ⅱ~Ⅲ pilon fractures

目的 探究筋膜切开减压联合负压封闭引流(VSD)在闭合性Ruedi-AllgowerⅡ~Ⅲ型pilon骨折患者治疗中的临床效果。方法 选择104例Ⅱ~Ⅲ型pilon骨折患者,按照随机数字表法分为观察组(52例)和对照组(52例)。对照组给予筋膜切开减压手术+常规治疗,观察组给予筋膜切开减压手术+VSD治疗,术后随访3个月。比较两组的围术期指标、踝与后足功能(AOFAS)评分、踝关节功能(Mazur)评分、踝关节恢复优良率和并发症发生率。结果 观察组住院时间、创面和骨折愈合时间短于对照组,差异均有统计学意义(t分别=11.45、15.15、2.06,P均<0.05);术后随访3个月,观察组患者的AOFAS评分和Mazur评分均高于对照组,差异均有统计学意义(t分别=11.73、16.46,P均<0.05),观察组的踝关节优良率高于对照组,术后并发症发生率低于对照组,差异均有统计学意义(χ^(2)分别=5.22、7.79,P均<0.05)。结论 筋膜切开减压联合VSD在闭合性Ruedi-AllgowerⅡ~Ⅲ型pilon骨折患者中的治疗效果明显,能有效缓解疼痛程度,改善关节受限,进而缩短康复进程,降低并发症发生概率。

Objective To explore the clinical curative effect of fasciotomy decompression combined with vacuum seal⁃ing drainage(VSD)in patients with closed type Ruedi-AllgowerⅡ-Ⅲpilon fractures.Methods A total of 104 pa⁃tients with type Ruedi-AllgowerⅡ-Ⅲpilon fractures were enrolled and divided into observation group(52 cases)and control group(52 cases)according to random number table method.The control group was given fasciotomy decompres⁃sion and routine treatment,while observation group was given fasciotomy decompression and VSD.All patients were fol⁃lowed up for 3 months after surgery.The perioperative indexes,score of American orthopedic foot and ankle society(AO⁃FAS),score of ankle function(Mazur),good rate of ankle recovery and incidence of complications were compared be⁃tween the two groups.Results The hospitalization time,wound and fracture healing time in observation group were shorter than those in control group(t=11.45,15.15,2.06,P<0.05).After 3 months of postoperative follow-up,the AO⁃FAS and Mazur scores in observation group were higher than those in control group(t=11.73,16.46,P<0.05),the good rate of ankle joint in observation group was higher than that in control group,the incidence of postoperative complica⁃tions was lower than that in control group(χ^(2)=5.22,7.79,P<0.05).Conclusion Curative effect of fasciotomy decom⁃pression combined with VSD is significant in patients with closed type Ruedi-AllgowerⅡ-Ⅲpilon fractures,which can effectively relieve pain and improve joint limitation,thus shorten rehabilitation process and reduce the incidence of com⁃plications.