胫骨远端锁定加压钢板与解剖型钢板内固定治疗Pilon骨折疗效比较

目的 比较胫骨远端锁定加压钢板与解剖型钢板内固定治疗Pilon骨折的临床疗效.方法 选择深圳市坪山新区人民医院骨科2014年1月至2015年10月期间收治的86例Pilon骨折患者为研究对象,根据随机数表法分为观察组和对照组,每组43例.对照组采用解剖型钢板内固定治疗,观察组采用锁定加压钢板治疗,比较两组患者的临床疗效.结果 观察组患者的手术时间、切口长度、术中出血量、术后切口感染发生率及术后愈合时间分别为(43.14±11.25)min、(3.62±1.08)cm、(106.48±32.46)mL、2.33%及(15.67±3.55)周,明显少于对照组的(53.16±15.28)min、(6.53±2.75)cm、(158.32±41.64)mL、13.95%及(17.46±3.68)周,差异均有统计学意义(P<0.05);术后随访1年时,观察组患者的踝关节评分优良率为90.70%,明显高于对照组的74.42%,差异有统计学意义(P<0.05).结论 胫骨远端锁定加压钢板治疗Pilon骨折手术创伤小,术后并发症少、愈合快,踝关节恢复理想.

Effect of locking compression plate internal fixation versus anatomical plate internal fixation for Pilon fracture

Objective To compare the clinical effect of locking compression plate internal fixation and anatom-ical plate internal fixation in the treatment of Pilon fractures. Methods Eighty-six patients with Pilon fracture, who were treated in the Department of Orthopedics in our hospital from January 2014 to October 2015, were selected and as-signed to receive anatomical plate internal fixation (the control group, n=43) and locking compression plate internal fixa-tion (the observation group, n=43) according to random number table. The clinical efficacy was compared between the two groups. Results The operation time, incision length, intraoperative bleeding, postoperative incision infection rate and postoperative healing time were (43.14 ± 11.25) min, (3.62 ± 1.08) cm, (106.48 ± 32.46) mL, 2.33% and (15.67 ± 3.55) weeks in the observation group, versus (53.16 ± 15.28) min, (6.53 ± 2.75) cm, (158.32 ± 41.64) mL, 13.95%and (17.46±3.68) weeks in the control group (P<0.05). During the one-year follow-up after surgery, the ex-cellent rate of ankle score in observation group was 90.70%, significantly higher than 74.42%in control group (P<0.05). Conclusion In the treatment of Pilon fracture, internal fixation with locking compression plate of distal tib-ia has advantages of less operative trauma, less postoperative complications, faster postoperative recovery, and better postoperative recovery of ankle joint.