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延期微创经皮锁定钢板治疗Ⅱ、Ⅲ型Pilon骨折的病例对照研究
Hits: 2309   Download times: 1357   Received:September 13, 2011    
作者Author单位UnitE-Mail
张智达 ZHANG Zhi-da 余姚市人民医院创伤骨科,浙江 余姚 315400  
叶秀益 YE Xiu-yi 余姚市人民医院创伤骨科,浙江 余姚 315400  
尚立勇 SHANG Li-yong 余姚市人民医院创伤骨科,浙江 余姚 315400  
徐荣明 XU Rong-ming 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics, the 6th Hospital of Ningbo, Ningbo 315040, Zhejiang, China  
朱彦昭 ZHU Yan-zhao 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics, the 6th Hospital of Ningbo, Ningbo 315040, Zhejiang, China allyssess@163.com 
期刊信息:《中国骨伤》2011年24卷,第12期,第1010-1012页
DOI:10.3969/j.issn.1003-0034.2011.12.010


目的:探讨延期微创锁定钢板内固定治疗Ⅱ、Ⅲ型Pilon骨折的疗效。

方法:2007年1月至2009年9月,采用切开复位解剖型钢板内固定(AP组)和微创经皮锁定加压钢板内固定(LCP组)治疗胫骨Ⅱ、Ⅲ型Pilon骨折共32例,其中AP组17例,男11例,女6例,年龄19~55岁,平均(37.4±13.3)岁;LCP组15例,男10例,女5例,年龄21~56岁,平均(34.6±11.3)岁。比较2组的手术时间、骨折愈合时间、骨折成角及踝关节功能情况。

结果:32例均获随访,时间12~25个月,平均(15.0±1.7)个月。AP组与LCP组平均手术时间分别为(76.5±8.3) min和(58.3±3.4) min,骨折愈合时间分别为(20.5±0.4)周和(15.7±0.2)周,正侧位成角之和分别为(6.6±0.5)°和(3.6±0.2)°,LCP组的上述指标均优于AP组(P<0.05).按照Kofoed踝关节功能评分标准,LCP组踝关节疼痛、行走功能、活动度3方面均优于AP组(P<0.05).

结论:延期微创经皮LCP内固定治疗Pilon骨折效果尚可,具有手术创伤小、固定强度高、骨折愈合快、踝关节功能恢复好等优点,是治疗Ⅱ、Ⅲ型Pilon骨折较好的手术方式之一。
[关键词]:骨折  踝关节  骨折固定术,内  病例对照研究
 
Case-control study on minimally invasive percutaneous locking compression plate internal fixation for the treatment of typeⅡand Ⅲ Pilon fractures
Abstract:

Objective: To explore the clinical efficacy of delayed open reduction and internal fixation with minimally invasive percutaneous locking compression plate for the treatment of typeⅡandⅢ Pilon fractures.

Methods: From January 2007 to September 2009,32 patients with typeⅡand Ⅲ Pilon fractures were treated with open reduction and anatomic plate fixation(AP group) and minimally invasive percutaneous locking compression plate osteosynthesis(LCP group). There were 11 males and 6 females in AP group,with an average age of (37.4±13.3) years (ranged,19 to 55 years). And there were 10 males and 5 females in LCP group,with an average age of (34.6±11.3) years(ranged,21 to 56 years). The operating time,fracture healing time,aligned angulation and ankle function were compared between the two groups.

Results: All the patients were followed up,and the during ranged from 12 to 25 months,with a mean of(15.0±1.7) months. The average operation time was(76.5±8.3) min for AP group and (58.3±3.4) min for LCP group;the average time of fracture healing was (20.5±0.4) weeks for AP group and(15.7±0.2) weeks for LCP group;the total angulation between anterior posterior film and lateral film was averaged(6.6±0.5)° for AP group and(3.6±0.2)° for LCP group. As to above index,the results of LCP group were better than those of AP group(P<0.05). According to Kofoed criteria for ankle joint,the results of LCP group were better than those of AP group in ankle joint pain,wakling and ankle joint function(P<0.05).

Conclusion: The method of minimally invasive percutaneous locking compression plate internal fixation is effective in the treatment of Pilon fracture with less invasion,faster bone union,more stabilized fixation,quicker recovery of ankle function and fewer complications,which is more advantaged for type Ⅱand Ⅲ Pilon fractures.
KEYWORDS:Fractures  Ankle joint  Fracture fixation,internal  Case control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:张智达,叶秀益,尚立勇,徐荣明,朱彦昭.延期微创经皮锁定钢板治疗Ⅱ、Ⅲ型Pilon骨折的病例对照研究[J].中国骨伤,2011,24(12):1010~1012
英文格式:ZHANG Zhi-da,YE Xiu-yi,SHANG Li-yong,XU Rong-ming,ZHU Yan-zhao.Case-control study on minimally invasive percutaneous locking compression plate internal fixation for the treatment of typeⅡand Ⅲ Pilon fractures[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(12):1010~1012
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