摘要
目的观察经前外侧联合内侧微创入路切开复位内固定手术治疗AO-C型Pilon骨折的疗效,为临床诊疗提供依据。方法选取2017年9月至2018年11月西安国际医学中心医院骨科收治的120例AO-C型Pilon骨折患者为研究对象,按随机数表法将患者分为对照组和观察组各60例。对照组采用前外侧入路手术治疗,观察组在此基础上联合内侧微创入路切开复位内固定手术治疗。比较两组患者的治疗效果及围术期情况,并记录治疗前后美国足踝外科协会(AOFAS)踝-后足评分、视觉模拟疼痛(VAS)评分、踝关节活动度,以及并发症发生情况。结果观察组患者的治疗总优良率为91.67%,明显高于对照组75.00%,差异有统计学意义(P<0.05);观察组患者的术中出血量(54.12±6.02)mL,明显低于对照组的(65.18±5.70)mL,骨折愈合时间为(12.56±3.12)周,明显短于对照组的(15.45±3.22)周,差异均有统计学意义(P<0.05);治疗后,两组患者的AOFAS评分和踝关节活动度均明显高于治疗前,且观察组分别为(68.12±5.12)分、(16.28±3.10)°,明显高于对照组的(56.22±4.60)分、(14.78±2.88)°,差异均有统计学意义(P<0.05);治疗后,两组患者的VAS评分均降低,且观察组为(1.89±0.31)分,明显低于对照组的(2.42±0.43)分,差异均有统计学意义(P<0.05);观察组患者的并发症总发生率为6.67%,明显低于对照组的20.00%,差异有统计学意义(P<0.05)。结论经前外侧联合内侧微创入路切开复位内固定手术治疗AO-C型Pilon骨折效果明显,且创伤小,利于早期进行功能锻炼,促进关节活动度恢复,并发症少,可在临床推广使用。
Objective To observe the effect of open reduction and internal fixation anterolateral combined with medial minimally invasive approach via in the treatment of AO-C Pilon fracture,and to provide basis for clinical diagnosis and treatment.Methods A total of 120 patients with AO-C Pilon fracture,who admitted to Department of Orthopaedics,Xi'an International Medical Center Hospital from September 2017 to November 2018,were selected and divided into the control group and the observation group according to random number table method,with 60 patients in each group.The control group was treated by anterolateral approach,and the observation group was treated by open reduction and internal fixation via anterolateral combined with medial minimally invasive approach.The treatment effect and perioperative situation of the two groups were compared,and the American Orthopaedic Foot and Ankle Society(AOFAS)ankle posterior foot score,Visual Analogue Pain(VAS)score,ankle joint activity and complications were recorded before and after treatment.Results The total excellent and good rate of treatment in the observation group was 91.67%,which was significantly higher than 75.00%in the control group(P<0.05);the intraoperative blood loss of the observation group was(54.12±6.02)mL,which was significantly lower than(65.18±5.70)mL of the control group,and the fracture healing time was(12.56±3.12)weeks,which was significantly shorter than(15.45±3.22)weeks of the control group(P<0.05);after treatment,the AOFAS score and ankle mobility of the two groups of patients were significantly higher than before treatment,and the observation group were(68.12±5.12)points and(16.28±3.10)°,respectively,which was significantly higher than corresponding(56.22±4.60)points,(14.78±2.88)°of the control group(P<0.05);the total incidence of complications in the observation group was 6.67%,which was significantly lower than 20.00%in the control group(P<0.05).Conclusion Anterior-lateral combined medial minimally invasive approach with open reduction and i
作者
徐振卫
李扬
王育才
吕向阳
XU Zhen-wei;LI Yang;WANG Yu-cai;LV Xiang-yang(Department of Orthopaedics,Xi'an International Medical Center Hospital,Xi'an 710000,Shaanxi,CHINA;Department of Orthopaedics,Tangdu Hospital,Air Force Military Medical University,Xi'an 710000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第15期1968-1971,共4页
Hainan Medical Journal
关键词
AO-C型Pilon骨折
前外侧入路
内侧微创入路
内固定
并发症
AO-C Pilon fracture
Anterolateral approach
Medial minimally invasive approach
Internal fixation
Complications
