期刊文献+

两种不同术式治疗Pilon骨折的疗效比较分析 被引量:15

Comparison of two surgical methods in the treatment of Pilon fracture
下载PDF
导出
摘要 目的探讨两种手术方式对Pilon骨折复位的效果及并发症的影响。方法选择77例Pilon骨折患者,分别采用两种手术方法进行治疗,其中采用分步延期ORIF法39例和有限内固定结合外固定支架法38例。术后采用Burwell-Charnley评价标准进行放射学的评价和Olerud-Molander评分标准进行临床疗效的评价,同时对并发症进行观察。结果在并发症方面,在术后8个月时,采用分步延期ORIF法的患者中,出现3例并发症;而采用有限内固定结合外固定支架法的患者中,出现9例并发症,两组比较差异有统计学意义(P<0.05)。在放射学评价方面,在术后8个月时,分步延期ORIF法中达到解剖复位为17例,功能复位18例,复位差3例;有限内固定结合外固定支架法达到解剖复位10例,功能复位16例,复位差9例,两组比较差异有统计学意义(P<0.05)。在临床疗效方面,分步延期ORIF法在上台阶、跑步、跳跃和支撑方面与B法比较,差异有统计学意义(P<0.05)。结论采用分步延期ORIF法治疗Ⅱ、Ⅲ型Pilon骨折,能有效维持解剖复位,减少术后并发症,并能达到较好的临床效果,值得推荐。 Objective To evaluate the influence of two surgical methods on the reduction effects and complications of Pilon fracture.Methods Seventy-seven patients with Pilon fracture were selected and divided into two groups.Patients in group A(n=39) underwent delay open reduction and internal fixation,while those in group B(n=38) were treated with limited internal fixation and external fixator.All the patients were followed up,and evaluated with the criteria of Burwell-Charnley and the criteria of Olerud-Molander.The complication was observed.Results Eight months of surgery,two patients in group A and 9 patients in group B had complications after,showing statistically significant difference between two group(P0.05).In the criteria of Burwell-Charnley,group A was significantly better than group B(P0.05).In the criteria of Olerud-Molander,group A was significantly better than group B in running,jumping and support and taking step(P0.05).Conclusion For treating type Ⅱ and Ⅲ fracture,delay open reduction and internal fixation can maintain anatomical reduction and reduce postoperative complications,which can achieve better clinical results and should be recommended.
出处 《海南医学》 CAS 2012年第8期35-38,共4页 Hainan Medical Journal
关键词 PILON骨折 分步延期ORIF法 有限内固定结合外固定支架法 效果 并发症 Pilon fracture Delay open reduction and internal fixation Limited internal fixation and external fixator Efficacy Complication
  • 相关文献

参考文献19

  • 1Ristiniemi J. External fixation of tibial pilon fractures and fracture healing[J].Acta Orthopaedica,2007,(326):3,5-34.
  • 2Rüedi TP,Allg(o)wer M. Fractures of the lower end of the tibia into the ankle-joint[J].Injury.British Journal of Accident Surgery,1969.92-99.
  • 3Tscheme H,Gotzen L. Fractures with soft tissue injuries[M].Beilin:Springer-Verlag,1984.1-58.
  • 4Burwell HN,Charnley AD. The treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement[J].Journal of Bone and Joint Surgery-British Volume,1965,(04):634-660.
  • 5Olerud C,Molander H. A scoring scale for symptom evaluation after ankle fracture[J].Archives of Orthopaedic and Trauma Surgery,1984,(03):190-194.
  • 6Horisberger M,Valderrabano V,Hintermann B. Posttraumatic ankle osteoarthritis after ankle-related fractures[J].Journal of Orthopaedic Trauma,2009,(01):60-67.doi:10.1097/BOT.0b013e31818915d9.
  • 7Dunbar RP,Barei DP,Kubiak EN. Early limited internal fixation of diaphyseal extensions in select pilon fractures:upgrading AO/OTA type C fractures to AO/OTA type B[J].Journal of Orthopaedic Trauma,2008,(06):426-429.doi:10.1097/BOT.0b013e31817e49b8.
  • 8Leung F,Kwok HY,Pun TS. Limited open reduction and Ilizarov external fixation in the treatment of distal tibial fractures[J].Injury.British Journal of Accident Surgery,2004,(03):278-283.
  • 9常山,刘战立,闫广华,蒋华,何涛,严小虎.有限内固定加动力型超踝关节外固定架治疗复杂Pilon骨折[J].中国骨与关节损伤杂志,2009,24(4):357-358. 被引量:14
  • 10高堪达,陶杰,王秋根,高伟,李豪青,李凡,朱力波,李夏,王建东,吴晓明,吴小峰,黄伟杰.外固定支架在高能量Pilon骨折分期治疗中的地位和意义探讨[J].中国矫形外科杂志,2008,16(12):881-884. 被引量:15

二级参考文献31

  • 1顾立强.Pilon骨折的分类与功能评价[J].中华创伤骨科杂志,2004,6(8):894-898. 被引量:141
  • 2罗从风,曾炳芳.Pilon骨折的治疗[J].中华创伤骨科杂志,2005,7(3):230-232. 被引量:97
  • 3刘文和 ,李杰锋 ,熊波 ,陈志伟 ,王斌 ,李先安 ,李康华 .单侧外固定支架治疗不同部位胫腓骨严重开放性骨折[J].中国骨与关节损伤杂志,2005,20(3):163-165. 被引量:30
  • 4Ruedi TP, Allgower M. The operative treatment of intra-articular fractures of the lower end of the tibia. Clin Orthop, 1979, (138): 105.
  • 5Okcu G, Aktuglu K. Intra-articular fractures of the tibial plafond. A comparison of the results using articulated and ring external fixators.J Bone Joint Surg Br, 2004, 86(6): 868.
  • 6Tarkin IS, Clare MP, Marcantonio A, et al. An update on the management of high-energy Pilon fractures. Injury, 2008, 39(2):142.
  • 7Chen SH, Wu PH, Lee YS, Long-term results of Pilon fractures. Arch Orthop Trauma Surg, 2007, 127(1): 55.
  • 8Golubovic Z, Macukanovic-Golubovic L, Stojiljkovic P, et al. External fixation combined with limited internal fixation in the treatment of Pilon tibia fractures. Vojnosanit Pregl, 2007, 64(5): 307.
  • 9Pollak AN, McCarthy ML, Bess RS, et al. Outcomes after treatment of high-energy tibial plafond fractures. J Bone Joint Surg Am, 2003, 85(10): 1893.
  • 10Harris AM, Patterson BM, Sontich JK, et al. Results and outcomes after operative treatment of high-energy tibial plafond fractures Foot Ankle Int, 2006, 27(4): 256.

共引文献40

同被引文献168

引证文献15

二级引证文献124

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部