| 袁光华,梅永珍,陈康,等.两种方式治疗Rüedi-Allgöwer Ⅲ型Pilon骨折的比较.骨科,2017,8(2): 112-116. |
| 两种方式治疗Rüedi-Allgöwer Ⅲ型Pilon骨折的比较 |
| Analysis of external fixation and open reduction and fixation for the treatment of Rüedi-Allgöwer type Ⅲ Pilon fractures |
| 投稿时间：2016-04-28 |
| DOI：10.3969/j.issn.1674-8573.2017.02.008 |
| 中文关键词: 胫骨骨折 骨折固定术，内 外固定器 病例对照研究 创伤和损伤 |
| 英文关键词: Tibial fractures Fracture fixation, internal External fixators Case-control studies Wounds and injuries |
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| 中文摘要: |
| 目的 比较有限内固定结合外固定支架与前正中联合后外侧入路切开复位内固定治疗Rüedi-Allgöwer Ⅲ型Pilon骨折的临床疗效。方法 回顾性分析2008年3月至2015年6月我科治疗117例Rüedi-Allgöwer Ⅲ型Pilon骨折病人的病例资料，男65例，女52例，年龄为20~67岁。根据手术方式不同分为两组：53例采用有限内固定结合外固定支架治疗（外固定组），64例采用前正中联合后外侧入路切开复位内固定治疗（切开复位组）。两组病人一般资料比较，差异均无统计学意义（均P＞0.05）。比较两组病人的手术时间、术中出血量、术后首次负重时间、早期并发症、远期并发症、Mazur功能评分。结果 术后病人均获得随访，随访时间为12~36个月，平均为（22.0±3.6）个月。两组病人术中出血量、术后首次负重时间和早期并发症情况比较，差异均无统计学意义（均P＞0.05）；手术时间、术后远期并发症及末次随访Mazur功能评分比较，差异均有统计学意义（均P＜0.05）。切开复位组治疗效果较对照组更优。结论 与有限内固定结合外固定支架治疗Rüedi-Allgöwer Ⅲ型Pilon骨折比较，前正中联合后外侧入路切开复位内固定治疗Rüedi-Allgöwer Ⅲ型Pilon骨折可以充分暴露骨折端，复位关节面满意，固定牢靠，患肢术后功能恢复远期疗效更好。 |
| 英文摘要: |
| Objective To compare limited internal fixation combined with external fixation vs. anterior median combined with posterolateral incision reduction and internal fixation for the treatment of Rüedi-Allgöwer type Ⅲ Pilon fractures. Methods From March 2008 to June 2015, The clinical data of 117 cases of Rüedi-Allgöwer type Ⅲ Pilon fractures were analyzed retrospectively. Fifty-three cases were given limited internal fixation combined with external fixation, and 64 cases were treated with anterior median combined with posterolateral approach for open reduction and internal fixation. Operation time, intraoperative blood loss, postoperative first load time, the early postoperative complications, the late postoperative complications, and Mazur function score were compared between two groups. Results All cases were followed up for 12-36 months (average 22.0±3.6 months). Intraoperative blood loss, postoperative first load time and the early postoperative complications had no significant difference between the two groups (P＞0.05). The operation time, the late postoperative complications and Mazur score at the end of the follow-up showed significant difference between the two groups (P＜0.05). Conclusion As compared with limited internal fixation combined with external fixation for the treatment of Rüedi-Allgöwer type Ⅲ Pilon fractures, the anterior median combined with posterolateral approach to open reduction and internal fixation can fully expose fractures, reduce the articular surface satisfactorily with stable fixation, and long-term effect of better functional recovery of limb after the operation. |
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