切开复位胫骨远端解剖锁定钢板内固定术治疗胫骨Pilon骨折的临床效果

摘要

Objective To analyze the efficiency and safety of using open reduction and internal fixation of tibia distal anterolateral anatomic locked plates in the treatment of patients with tibia Pilon fracture. Methods 76 patients whowere diagnosed with tibia Pilon fracture definitely in our hospital from October 2005 to December 2014 were selected as the object of the study.All patients were randomly divided into study group and control group.There were 38 patients in control group and they received conventional limited internal fixation while there were also 38 patients in study group and they received the open reduction and internal fixation of tibia distal anterolateral anatomic plates.The opera-tion time,operation efficiency,recovery time and complication after operation were observed and compared between con-trol group and study group. Results The effective rate of study group was up to 92.1% and the rate of the control group was only 73.7%(P<0.05).The operation time of study group was (75.8±11.2)min and it was significantly shorter than the control group(90.7±13.6)min.The recovery time of study group was(20.3±2.9)weeks and it was significantly shorter than the control group (28.5±3.7)weeks.Both the patients of the two groups had some complication,such as the wound infec-tion,the stiffness or engorgement of the ankle mortise.The rate of complication in study group was only 15.8% while the control group was up to 36.8%,the rate of the control group was obviously higher than the study group (P<0.05). COn-clusiOn The clinic efficiency of the open reduction and internal fixation of tibia distal anterolateral anatomic locked plates in the treatment of patients with tibia Pilon fracture is better than the conventional limited internal fixation,the operation time and the recovery time is greatly shorter and the rate of complication is exceedingly low.It is worthy of widely spreading in clinic.%目的 探究切开复位胫骨远端解剖锁定钢板内固定术治疗胫骨Pilon骨折的临床效果和安全性. 方法 选择2005年10月~2014年12月于我院接受治疗的76例已确诊为Pilon骨折的患者作为研究对象,随机分为实验组和对照组. 其中对照组患者38例,采用常规钢板内固定术;实验组患者46例,接受切开复位胫骨远端解剖锁定钢板内固定术,观察比较两组患者手术时间、治疗效果、术后恢复时间及术后并发症. 结果 实验组和对照组接受手术后有效率分别为92.1%和73.7%,两组比较差异有统计学意义(P<0.05). 实验组患者手术时间为(75.8± 11.2)min,对照组为(90.7±13.6)min,两组比较差异有统计学意义(P<0.05). 实验组患者术后恢复时间为(20.3± 2.9)周,对照组为(28.5±3.7)周,实验组显著短于对照组(P<0.05).两组均有患者发生伤口感染、踝关节僵硬、踝关节肿胀等并发症,对照组患者并发症发生率为36.8%,显著高于实验组的15.8%(P<0.05). 结论 切开复位胫骨远端解剖锁定钢板内固定术治疗胫骨Pilon骨折疗效显著,优于常规钢板内固定术,手术时间及关节功能恢复时间短,并发症发生率低且安全可靠,值得临床推广应用.