摘要
目的:探讨经小腿前外侧单一切口治疗伴有腓骨骨折的Pilon骨折的可行性。方法:选择收治的33例伴腓骨下端骨折的Pilon骨折患者,均需行骨折切开复位钢板内固定。采用单盲试验随机分成两组,其中A组17例予以传统前内加后外侧切口行切开复位内固定,B组16例应用单一前外侧切口行切开复位内固定治疗,记录手术时间,观察创面愈合情况,按Mazur评定标准评估疗效。结果:所有患者均未出现钢板外露、感染等严重的手术并发症。其中A组17例患者有4例术后出现局部皮肤小面积坏死,3例2周内自行愈合,1例3周后愈合;按照Mazur评分标准评估疗效,其中优11例,良5例,可1例。B组行16例患者手术有2例患者出现局部皮肤小面积坏死,1周内自行愈合;按照Mazur评分标准评估疗效,其中优10例,良4例,可2例。评价两组临床疗效及软组织恢复情况,均获良好,且应用单一前外侧切口较传统入路并未增加手术时间,统计学分析二组手术时间和疗效无差异。结论:小腿前外侧改良单一切口治疗伴有腓骨骨折的Pilon骨折,可避免局部软组织进一步损伤。
Objective To explore the feasibility of treating Pilon fracture with fibular fracture through a single anterolateral incision of the lower leg.Methods The patients of Pilon fracture with lower fibula fracture(33 cases)were selected and treated,all of which required open reduction and internal fixation with steel plate.Single blind test was used to randomly divide the patients into two groups,17 cases in group A treated with traditional anterolateral incision and posterolateral incision for open reduction and internal fixation,and 16 cases in group B treated with single anterolateral incision for open reduction and internal fixation.The operation time was recorded,the wound healing was observed,and the curative effect was evaluated according to Mazur evaluation standard.Results No serious surgical complications such as exposure of steel plate and infection occurred in all patients.Among the 17 patients in group A,4 had local skin necrosis after operation,3 healed spontaneously within 2 weeks,and 1 healed after 3 weeks.According to Mazur scoring criteria,11 cases were excellent,5 cases were good and 1 case was fair.In group B,16 patients underwent surgery,and 2 patients had local skin necrosis with small area,which healed by itself within 1 week.The curative effect was evaluated according to Mazur scoring standard,of which 10 cases were excellent,4 cases were good and 2 cases were fair.The clinical efficacy and soft tissue recovery of the two groups were evaluated with good results,and the application of a single anterolateral incision did not increase the operation time compared with the traditional approach.Statistical analysis showed that there was no difference in the operation time and efficacy between the two groups.Conclusion Improved single incision on the anterolateral leg for Pilon fracture with fibular fracture can avoid further injury of local soft tissue.
作者
陈建良
许勇
姚光校
CHEN Jian-liang;XU Yong;YAO Guang-xiao(Shangyu Hospital of Traditional Chinese Medicine,Shaoxing City,Shaoxing (312360),China)
出处
《中国中西医结合外科杂志》
CAS
2019年第3期303-306,共4页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
前外侧切口
PILON骨折
腓骨下端骨折
疗效
Anterolateral incision
pilon fracture
fracture of lower fibula
curative effect
