摘要
目的探讨新型胫骨远端前侧解剖型锁定接骨板（LAP）治疗pilon前柱骨折的临床疗效。方法回顾性分析2014年2月至2015年2月采用新型胫骨远端前侧解剖型锁定接骨板治疗的13例pilon前柱骨折患者资料，男10例，女3例；年龄18—67岁，平均44．8岁；均为单侧闭合性骨折；左侧8例，右侧5例；骨折按照AO／OTA分型：43-B3型5例，43-c1型4例，43．c2型3例，43．c3型1例。按照pilon骨折的解剖四柱理论分型为累及前柱的骨折。均采用前侧手术入路进行切开复位内固定。术后分别采用Burwell．Charnley评估标准、美国足踝外科协会（AOFAS）踝．后足评分及Tornetta评价标准评价疗效。结果本组患者平均手术时间为80．5min（70～120min），平均住院时间为7．9d（6～14d）。所有患者术后获3—14个月（平均8个月）随访，均未出现切口感染、化脓、深静脉血栓形成、皮肤坏死、骨折延迟愈合或不愈合及骨髓炎等并发症。Burwell-Charnley放射学标评估准：解剖复位7例，复位一般5例，复位差1例；术后随访踝关节AOFAS踝．后足评分平均为82．4分（75～88分）；Tornetta骨折临床治疗结果评价：优8例，良3例，差2例。结论新型胫骨远端LAP在治疗pilon前柱骨折的过程当中，具有安放简单、固定牢靠、踝关节功能恢复满意、术后并发症少等优点，具有较高的临床应用价值。
Objective To discuss the clinical efficacy of a novel locking anatomical plate （LAP） at the anterior distal tibia in the treatment of pilon anterior column fractures. Methods From February 2014 to February 2015, 13 cases of pilon anterior column fracture were treated with a novel LAP at the anterior distal tibia. They were 10 men and 3 women, from 18 to 67 years of age （average, 44.8 years）. All fractures were unilaterally closed, with 8 cases of the left side and 5 the right side. According to AO/OTA classifi- cation, 5 cases belonged to type 43-B3, 4 to type 43-C1, 3 to type 43-C2, and one to type 43-C3. According to the four-column theory, the fractures all belonged to those involving the anterior column. All fractures were treated by open reduction and internal fixation through the anterior surgical approach. The clinical efficacy was assessed using the Burwell-Charnley radiographic criteria, the ankle-hind-foot scoring system of American Orthopedic Foot and Ankle Society （AOFAS） and the Tornetta evaluation system. Results The operation time ranged from 70 to 120 minutes （average, 80.5 minutes）. The average hospital stay was 7.9 days （from 6 to 14 days）. This group was followed up for 3 to 14 months （average, 8 months） . There were no such complications as incision infection, suppuration, deep vein thrombosis, skin necrosis, delayed union, nonunion or osteomyelitis. By the Burwell-Charnley radiographic criteria, anatomic reduction was achieved in 7 cases, moderate reduction in 5 and poor reduction in one. The postoperative AOFAS ankle-hind-foot scores averaged 82.4 points （from 75 to 88 points）. By the Tornetta evaluation system, 8 cases were excellent, 3 fine and 2 poor. Conclusion In the treatment of anterior column pilon fractures, the novel LAP at the anterior distal tibia shows the advantages of easy implantation, rigid stabilization, satisfactory functional recovery of the ankle joint, and limited postoperative complications.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2015年第12期1024-1028,共5页
Chinese Journal of Orthopaedic Trauma
基金
国家自然科学基金（81171721）
关键词
胫骨骨折
骨折固定术
内
骨板
前侧入路
四柱理论
Tibial fracture
Fracture fixation, internal
Bone plate
Anterior approach
Four column theory
