摘要
目的:探讨采用踝关节前内侧入路联合后外侧入路延期内固定治疗Pilon骨折合并腓骨骨折的临床疗效。方法:自2016年12月至2018年12月采用踝关节前内侧入路联合后外侧入路三钢板复位固定治疗18例Pilon骨折合并腓骨骨折患者,男12例,女6例;年龄38~51(44.00±3.45)岁;根据Rüedi和Allg?wer分型,Ⅱ型9例,Ⅲ型9例。所有病例为闭合性骨折。术后7 d采用Burwell-Charnley标准对关节面骨折复位情况进行评价,比较术后9、12个月Mazur踝关节评分以评价术后踝关节功能改善情况。结果:18例患者均获随访,时间12~18(14.00±1.57)个月。术后7 d根据Burwell-Charnley标准对关节面骨折复位质量进行评定:优13例,良5例。所有骨折愈合,愈合时间9.5~15(12.00±1.43)个月。所有患者术后无感染、皮肤坏死、内固定松动断裂及骨折复位丢失等并发症。根据Mazur踝关节评分标准,术后12个月(92.11±5.28)分较术后9个月(89.33±5.20)分明显提高(t=7.976,P<0.001)。结论:延期踝关节前后联合入路三接骨板内固定治疗Pilon骨折合并腓骨骨折,术中操作便捷,复位满意,固定持续可靠,术后并发症少,踝关节功能恢复满意。
Objective:To explore clinical effect of delayed internal fixation through anteromedial and posterolateral approach of ankle joint in treating Pilon fracture combined with fibula fracture.Methods:From December 2016 to December2018,18 patients with Pilon and fibula fracture treated by internal fixation through anteromedial and posterolateral approach of ankle joint with three plates,including 12 males and 6 females,aged from 38 to 51 years old with an average of(44.00±3.45) years old.According to classification of Ruedi and Allgower,9 patients were type Ⅱ and 9 patients were type Ⅲ.All patients were closed fractures.Burnell Charnley standard was used to evaluate reduction of articular surface fracture at 7 days after operation,and Mazur ankle evaluation grading system was used to compare the improvement of ankle function between 9 and 12 months after operation.Results:All patients were followed up for 12 to 18 months with an average of(14.00±1.57) months.According to standard of Burwell Charnley at 7 days after operation,13 patients got excellent results and 5 patients good.All fracture healed well from 9.5 to 15 months with an average of(12.00±1.43) months.No infection,skin necrosis,loosen and broken of internal fixation,loosing of fracture reduction occurred.Mazur ankle joint score at 12 months(92.11±5.28) scores was higher than 9 months(89.33±5.20) scores(t=7.976,P<0.001).Conclusion:Delayed internal fixation through anteromedial and posterolateral approach of ankle joint for Pilon fracture combined with fibula fracture has advantages of simple operation,satisfied reduction,stable fixation,less postoperative complications and satisfied ankle joint function.
作者
赵海洋
ZHAO Hai-yang(Department of Orthopaedics,Beijing Beiya Orthopaedic Hospital Trauma,Beijing 102445,China)
出处
《中国骨伤》
CAS
CSCD
2020年第3期257-260,共4页
China Journal of Orthopaedics and Traumatology
关键词
胫骨骨折
腓骨
骨折固定术
内
Tibial fractures
Fibula
Fracture fixation,internal
