The Eleventh Department of Orthopaedics, The Fifth Hospital of Harbin, Harbin, China.
Clin Interv Aging. 2017 Nov 28;12:2033-2038. doi: 10.2147/CIA.S140272. eCollection 2017.
Pilon fracture is so complex that its therapy poses a great challenge to surgeons. Few studies have compared arthroscopy-assisted minimally invasive therapy and external fixation combined with limited internal fixation (EFLIF), and an optimal choice of surgical therapy remains unclear in patients with type III Pilon fracture. Moreover, to our knowledge, very few studies have specifically evaluated arthroscopy-assisted minimally invasive therapy in Chinese elderly with type III Pilon fracture. The current study was performed to observe the clinical application of arthroscopy-assisted minimally invasive therapy, compared with EFLIF, in Chinese elderly with type III Pilon fracture.
There were 230 Chinese elderly with type III Pilon fracture assigned to undergo EFLIF (group A, n=115) or arthroscopy-assisted minimally invasive therapy (group B, n=115), and followed up for 1 year after surgery.
Age, sex, causes, sides and types of Pilon fractures were not different between the two groups (>0.05 for all). Compared with EFLIF, arthroscopy-assisted minimally invasive therapy achieved a better reduction result, bone union and Mazur system (<0.05 for all). Patient satisfaction, screw loosening and infection prevalence were not different between the two groups (>0.05 for all). There was no skin necrosis in the two groups. Traumatic arthritis had a significantly lower prevalence in participants with arthroscopy-assisted minimally invasive therapy than EFLIF (<0.05 for all).
Compared with EFLIF, arthroscopy-assisted minimally invasive therapy for type III Pilon fracture significantly improved reduction result, bone union and functional status, and decreased traumatic arthritis, demonstrating that arthroscopy-assisted minimally invasive therapy is an optimal choice for type III Pilon fracture in Chinese elderly.
Pilon 骨折非常复杂，其治疗对外科医生来说是一个巨大的挑战。很少有研究比较过关节镜辅助微创治疗和外固定架结合有限内固定（EFLIF），对于 III 型 Pilon 骨折患者，哪种手术治疗方法更优仍不明确。此外，据我们所知，很少有研究专门评估过关节镜辅助微创治疗在中国老年 III 型 Pilon 骨折患者中的应用。本研究旨在观察关节镜辅助微创治疗在我国老年 III 型 Pilon 骨折患者中的临床应用，与 EFLIF 进行比较。
将 230 例 III 型 Pilon 骨折的中国老年患者分为 EFLIF 组（A 组，n=115）和关节镜辅助微创治疗组（B 组，n=115），术后随访 1 年。
两组患者的年龄、性别、病因、侧别和 Pilon 骨折类型无差异（均>0.05）。与 EFLIF 相比，关节镜辅助微创治疗的复位效果、骨愈合和 Mazur 系统评分更好（均<0.05）。两组患者的患者满意度、螺钉松动和感染发生率无差异（均>0.05）。两组均无皮肤坏死。与 EFLIF 相比，关节镜辅助微创治疗组创伤性关节炎的发生率明显较低（均<0.05）。
与 EFLIF 相比，关节镜辅助微创治疗 III 型 Pilon 骨折明显改善了复位效果、骨愈合和功能状态，降低了创伤性关节炎的发生率，表明关节镜辅助微创治疗是中国老年 III 型 Pilon 骨折的最佳选择。
