胫骨远端后外侧入路术治疗Pilon骨折的疗效及并发症情况分析

Observation on the Efficacy and Complications of the Treatment of Pilon fracture Through the Posterior Lateral Approach of the Distal Tibia

目的分析Pilon骨折患者实施治疗过程中选择采取胫骨远端后外侧入路术的具体疗效以及并发症出现情况。方法选取2022年6月—2023年6月广东省佛山市顺德和平外科医院收治的66例Pilon骨折患者为研究对象,借助双色球法分为参照组和探究组,各33例。参照组患者实施胫骨远端前内侧入路术,探究组患者实施胫骨远端后外侧入路术。对比分析两组Pilon骨折患者在接受治疗后恢复用时相关数据、美国足与踝关节协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足功能评分的评分数据以及恢复期间并发症出现情况。结果治疗后,探究组患者术后恢复阶段的肿胀消失用时、切口愈合用时、骨折愈合用时短于参照组,差异有统计学意义(P<0.05);探究组患者其术后7 d、术后1个月以及术后3个月的踝关节AOFAS评分则显著高于参照组,差异有统计学意义(P<0.05);探究组患者在恢复期间相关并发症发生率为6.06%,低于参照组的24.24%,差异有统计学意义(χ^(2)=4.243,P<0.05)。结论临床治疗Pilon骨折患者过程中选择胫骨远端后外侧入路术可取得较为理想的治疗效果,可促使患者的踝关节功能获得明显改善,同时还可促使患者更快恢复,推荐参考运用。

Objective To analyze the specific efficacy and complications of posterolateral approach to distal tibia in patients with Pilon fracture.Methods A total of 66 patients with Pilon fracture admitted by Shunde Peace Surgical Hospital of Foshan City,Guangdong Province from June 2022 to June 2023 were selected,and 33 cases were divided into reference group and exploration group by random two-color sphere method.The anteromedial approach to the distal tibia was performed for patients in the reference group and posterolateral approach to the distal tibia for patients in the exploration group.The two groups of patients with Pilon fracture were compared and analyzed on the time taken to recover after treatment,the American orthopedic Foot and Ankle Society(AOFAS)ankle and hindfoot function score,and complications during recovery.Results The data of swelling disappearance,incision healing time and fracture healing time in the postoperative recovery stage of the postoperative recovery stage in the postoperative exploration group were significantly lower than those in the reference group,the differences were statistically significant(P<0.05).In the exploration group,the AOFAS score of the ankle joint,7 d,1 month and 3 month postoperative,were significantly higher than those of the reference group,the differences were statistically significant(P<0.05),and the overall incidence rate of related complications during recovery in the exploration group was 6.06%,which was less significant than that of 24.24%in the reference group,the difference was statistically significant(χ^(2)=4.243,P<0.05).Conclusion In the clinical treatment of patients with Pilon fracture,the posterolateral approach to the distal tibia can achieve a more ideal therapeutic effect,which can significantly improve the patient's ankle function,and promote the patient's recovery faster.