| 改良内侧入路治疗内侧柱压缩性Pilon骨折 |
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Received:October 11, 2021
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| 作者 | Author | 单位 | Unit | E-Mail |
| 唐润 |
TANG Run |
西安医学院, 陕西 西安 710021 |
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| 杨杰 |
YANG Jie |
西安交通大学附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Xi'an Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 李毅 |
LI Yi |
西安交通大学附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Xi'an Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 常鑫 |
CHANG Xin |
西安医学院, 陕西 西安 710021 |
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| 梁晓军 |
LIANG Xiao-jun |
西安交通大学附属红会医院足踝外科, 陕西 西安 710054 |
Department of Foot and Ankle Surgery, Xi'an Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
liangjun33369@163.com |
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| 期刊信息：《中国骨伤》2022年35卷，第3期，第248-252页 |
| DOI：10.12200/j.issn.1003-0034.2022.03.010 |
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目的: 探讨改良内侧切口治疗内侧柱压缩性Pilon骨折的临床疗效，并评估其安全性。
方法: 回顾性分析自2015年1月至2019年1月，西安交通大学附属红会医院足踝外科连续住院手术治疗的31例内侧柱压缩性Pilon骨折患者。根据入院时的影像学资料，31例均诊断为闭合性 Pilon骨折，术前X线片及三维CT均显示为内侧柱压缩性骨折。所有患者采用改良内侧切口行切开复位内固定治疗，且资料完整，其中男23例，女8例；年龄22~65（39.5±16.2）岁。所有患者采用改良内侧入路，联合其他入路辅助显露骨折断端。外伤至手术时间7~20（9.5±5.5） d；术后定期随访切口及骨折愈合情况。
结果: 31例均获得随访，随访时间13~25（15.7±5.5）个月。术前、术后常规X线及三维CT检查，解剖复位8例，解剖复位率25.81%；至末次随访，31例骨折均达到骨性愈合，愈合时间11~22（14.3±4.7）周。末次随访时美国足踝外科协会（American Orthopaedic Foot and Ankle Society，AOFAS）踝与后足评分75~89（80.5±4.9）分，优0例，良24例，中7例，差0例。
结论: Pilon骨折采用改良内侧入路可直接显露胫骨远端后内侧、内侧及前内侧，直视下复位后内侧和内侧压缩塌陷关节面并进行固定，临床疗效满意，伤口并发症少，对于以内侧关节面压缩为主的Pilon骨折，可推荐使用。 |
| [关键词]:手术切口 Pilon骨折 骨折,压缩性 |
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| Clinical results of modified medial approach in the treatment of Pilon fracture with medial column compression |
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Abstract:
Objective: To explore the clinical results of modified medial incision in the treatment o f Pilon fracture with medial column compression and evaluate its safety.
Methods: Thirty-one patients of Pilon fracture with medial column compressiom accepted surgical treatments in the Department of Foot and Ankle at Honghui Hospital of Xi'an Jiaotong University from January 2015 to January 2019. According to the imaging data at admission,31 cases were diagnosed as closed Pilon fractures,and both preoperative X-ray and 3D CT scan were shown as medial column compressive fractures. All patients underwent modified medial incision with complete data,including 23 males and 8 females;ranging in age from 22 to 65 years old,with an average of (39.5±16.2) years old. All patients underwent modified medial approach combined with other approaches to expose the broken end of fracture. The time from trauma to operation ranging from 7 to 20 days,with a mean of(9.5±5.5) days. The incision and fracture healing were followed up regularly after operation.
Results: All patients were followed up with an average of(15.7±5.5) months(ranged,13 to 25 months). Preoperative and postoperative routine X-ray and 3D CT examination showed anatomical reduction in 8 cases,and the anatomical reduction rate was 25.81%. Up to the latest follow-up,all 31 fractures had achieved bone healing,and the healing time ranged from 11 to 22 weeks,with a mean of (14.3±4.7) weeks. At the latest follow-up,the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scores ranged from 75 to 89,with a mean of 80.5±4.9,24 patients got a good result,7 fair.
Conclusion: The improved medial approach for Pilon fracture can directly expose the posterior medial,medial and anterior medial of the distal tibia. After reduction under direct vision,the medial compressed and collapsed articular surface are fixed. The clinical curative effect is satisfactory and the wound complications are less. It is recommended for Pilon fracture where compression of the medial articular surface is predominant. |
| KEYWORDS:Surgical incision Pilon fracture Fractures,compression |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 唐润,杨杰,李毅,常鑫,梁晓军.改良内侧入路治疗内侧柱压缩性Pilon骨折[J].中国骨伤,2022,35(3):248~252 |
| 英文格式: | TANG Run,YANG Jie,LI Yi,CHANG Xin,LIANG Xiao-jun.Clinical results of modified medial approach in the treatment of Pilon fracture with medial column compression[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(3):248~252 |
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