摘要
目的：探讨切开复位内固定术治疗Pilon骨折的手术时机选择,寻找最佳手术时间。方法：选择2008年5月-2012年6月的55例Pilon骨折患者作为研究对象,将其分为A组27例和B组28例,A组患者于伤后3-7d给予切开复位内固定术,B组分步延期,在伤后7-21d待软组织肿胀消退后再进行切开复位内固定术。观察两组创面与骨折的愈合状况,并对踝关节功能进行评估。结果：A组愈合平均时间为（18.7±3.1）周,并发症方面为切口裂开和浅表感染各3例;固定物外露和骨髓炎各1例;踝关节功能评价方面11例优,9例良,7例差。B组平均骨折愈合时间为（15.4±2.4）周;只有2例患者发生浅表感染;踝关节功能评价16例优,9例良,3例差。两组患者在骨折愈合时间、伤口愈合情况和踝关节功能恢复情况方面差异具有统计学意义（P〈0.05）。结论：Pilon骨折手术时机的选择对手术效果具有关键的影响,分步延期手术可以缩短骨折愈合进程,改善愈合效果,促进踝关节功能的进一步康复,应加强临床中的推广力度。
Objective：To discuss the operation timing of treating pilon＇s bone fracture by the method of open reduction and internal fixation,finding out the best timing.Methods：We chose 55 patients as the object who got pilon＇s bone fracture since May 2008 to June 2012.Then they were divided into 28cases（group A）and 27cases（group B）.Patients in group A treated by method of open reduction and internal fixation in 3to 7days after they got the illness;patients in group B treated by method of open reduction and internal fixation in 7to 21 days after they got the illness and the swell of soft tissues had faded away.Then observing the face of the wound and the healing of fracture and evaluating the ankle function.Results：In the group A,the patients average healing time was（18.7±3.1）weeks.3patients got complications of incision dehiscence and 3patients got complications of superficial infection.There was 1patient who got fixtures exposed and 1patient who got osteomyelitis.In the ankle function evaluation,there were 11 patients who were excellent,9patients who were good and 7patients who were bad.In the group B,the patients average healing time was（15.4±2.4）weeks.Only 2patients got complications of superficial infection.In the ankle function evaluation,there were 16 patients who were excellent,9patients who were good and 3patients who were bad.Conclusion：The Pilon fracture surgery timing has a critical influence on operation effects.The fractional delay surgery can shorten fracture healing process,improve the healing effects,promote the further recovery of ankle joint function.So we should strengthen the promotion of fractional delay surgery in clinical application.
出处
《医学理论与实践》
2015年第1期13-14,24,共3页
The Journal of Medical Theory and Practice
关键词
PILON骨折
切开复位内固定术
手术时机
Pilon＇s bone fracture
Open reduction and internal fixation
Operation timing
