后内侧与后外侧入路内固定术治疗踝关节后Pilon骨折的效果对比

Effect Comparison of Posterior Medial Versus Posterolateral Instrumpexy for Posterior Pilon Fractures

目的对比后内侧与后外侧入路固定术治疗踝关节后Pilon骨折的临床效果。方法回顾性分析2021年6月至2023年6月郑州大学附属洛阳中心医院收治的经后内侧入路内固定术治疗的31例踝关节后Pilon骨折患者资料,纳入后内侧组;选择同期于郑州大学附属洛阳中心医院行经后外侧入路内固定术治疗的31例患者资料,纳入后外侧组。记录两组患者手术相关指标、术后2个月脚踝恢复情况以及随访期间并发症发生情况。结果后内侧组手术时间、住院时间均短于后外侧组,术中出血量少于后外侧组(P<0.05)。后内侧组术后2个月踝关节功能恢复优良率高于后外侧组(P<0.05)。两组间并发症发生率比较,差异无统计学意义(P>0.05)。结论后内侧与后外侧入路内固定术治疗踝关节Pilon骨折,术后并发症发生率接近,但相对于后外侧入路,后内侧入路内固定术手术用时短、术中出血量少,且能实现早期恢复出院,术后短期脚踝功能恢复情况更理想。

Objective To compare the clinical effect of posteromedial and posterolateral approach fixation in the treatment of Pilon fracture of ankle.Methods The data of 31 patients with Pilon fracture of ankle joint treated by posterolateral approach from June 2021 to June 2023 in Luoyang Central Hospital Affiliated to Zhengzhou University were retrospectively analyzed and included in the posterolateral group.Data of 31 patients who underwent postlateral approach internal fixation in Luoyang Central Hospital affiliated to Zhengzhou University were selected and included in the posterolateral group.Surgery-related indexes,ankle recovery 2 months after surgery and complications during follow-up were recorded in both groups.Results The operative time and hospital stay in the posteromedial group were shorter than those in the posteromedial group,and the intraoperative blood loss was less than that in the posteromedial group(P<0.05).The excellent and good recovery rate of ankle joint function 2 months after operation in posteromedial group was higher than that in posteromedial group(P<0.05).There was no significant difference in the incidence of complications between two groups(P>0.05).Conclusion The posterior and medial and posterolateral instrumentation for ankle Pilon fracture has a close incidence of postoperative complications,but compared with the posterior and lateral approach,the posterior and medial instrumentation has a short operation time,less intraoperative bleeding amount,and can achieve early recovery and discharge,and the short-term recovery of ankle function is more ideal.