微创经皮锁定加压钢板内固定治疗Ⅱ、Ⅲ型Pilon骨折的病例对照研究

[Case-control study on minimally invasive percutaneous locking compression plate internal fixation for the treatment of type II and III pilon fractures].

作者信息

Zhang Zhi-Da, Ye Xiu-Yi, Shang Li-Yong, Xu Rong-Ming, Zhu Yan-Zhao

机构信息

Department of Orthopaedics, the 6th Hospital of Ningbo, Ningbo 315040, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2011 Dec;24(12):1010-2.

PMID:22276510

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 type II and III Pilon fractures.

METHODS

From January 2007 to September 2009, 32 patients with type II and 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) degrees for AP group and (3.6 +/- 0.2) degrees 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 II and III Pilon fractures.

摘要

目的

探讨微创经皮锁定加压钢板延迟切开复位内固定治疗Ⅱ型和Ⅲ型Pilon骨折的临床疗效。

方法

2007年1月至2009年9月，对32例Ⅱ型和Ⅲ型Pilon骨折患者分别采用切开复位解剖钢板固定（AP组）和微创经皮锁定加压钢板接骨术（LCP组）治疗。AP组男11例，女6例，平均年龄（37.4±13.3）岁（19～55岁）。LCP组男10例，女5例，平均年龄（34.6±11.3）岁（21～56岁）。比较两组的手术时间、骨折愈合时间、成角情况及踝关节功能。