L型胫骨远端前外侧钢板在Pilon骨折中的应用

Application of L-type Anterolateral Distal Tibial Plate in Pilon Fractures

目的研究L型胫骨远端前外侧钢板应用于Pilon骨折患者临床治疗中的疗效。方法随机选取2020年1月—2023年1月玉门市第一人民医院收治的50例Pilon骨折患者作为研究对象,根据手术方案分为两组,每组25例,对照组接受内侧入路普通钢板固定治疗,观察组应用L型胫骨远端前外侧钢板治疗。比较两组踝关节功能改善情况、应激指标水平变化情况、手术指标、并发症发生情况。结果观察组踝关节功能改善情况优于对照组,差异有统计学意义(Z=2.038,P<0.05)。观察组手术时间、术后首次下床时间、骨折愈合时间均短于对照组,差异有统计学意义(P均<0.05)。观察组术后C反应蛋白(C-reactive protein,CRP)、前列腺素E2(prostaglandin E2,PGE2)水平均低于对照组,超氧化物歧化酶(superoxide dismutase,SOD)水平高于对照组,差异有统计学意义(P均<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论L型胫骨远端前外侧钢板于Pilon骨折患者中应用所获疗效满意,可有效改善患者的踝关节功能,且治疗所致应激损伤较小。

Objective To study the efficacy of L-type anterolateral distal tibial plate application in the clinical treatment of patients with Pilon fracture.Methods A total of 50 patients with Pilon fracture admitted to the First People's Hospital of Yumen City from January 2020 to January 2023 were randomly selected as the study objects and divided into two groups according to the surgical plan,with 25 cases in each group.The control group received medial approach ordinary plate fixation treatment,and the observation group was treated with L-shaped distal anterolateral tibial plate treatment.Ankle joint function,changes in stress index levels,operative index and complication were compared between the two groups.Results The improvement of ankle joint function in the observation group was better than that of control group,and the difference was statistically significant(Z=2.038,P<0.05).The operation time,the first time to get out of bed after surgery and the fracture healing time in the observation group were shorter than those in the control group,and the differences were statistically significant(all P<0.05).The levels of C-reactive protein(CRP)and prostaglandin E2(PGE2)in the observation group were lower than those in the control group,while the level of superoxide dismutase(SOD)was higher than that in the control group,and the differences were statistically significant(all P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of L-type anterolateral distal tibial plate in patients with Pilon fracture is satisfied,which can effectively improve the ankle function of the patients,and the stress damage caused by the treatment is small.