Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei Province, No. 139 Ziqiang Road, Shijiazhuang, 050051, People's Republic of China.
Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.
Sci Rep. 2022 Apr 30;12(1):7074. doi: 10.1038/s41598-022-11150-7.
The present study aims to introduce a technique combining double reverse traction repositor (DRTR) with minimally invasive plate osteosynthesis (MIPO) in the surgical treatment of pilon fractures and to observe the efficiency of this approach during a short-term follow-up period. From January to December 2018, patients with pilon fractures who were treated by MIPO with DRTR were reviewed. The demographic and fracture characteristics, surgical data, and prognostic data of 24 patients were extracted. In all 24 patients, closed reduction was achieved with the MIPO technique, and excellent functional and radiological outcomes were observed. The average duration of surgery and intraoperative blood loss were 95.0 ± 14.2 min and 152.1 ± 52.1 ml, respectively. A mean of 16.0 ± 1.9 intraoperative fluoroscopies were conducted. At the 12-month follow-up evaluation, the average AOFAS score was 85.2 ± 5.1. Anatomic or good reduction was observed in 23 (95.8%) patients. The mean ranges of motion of dorsiflexion and plantarflexion were 11.0 ± 2.7 and 32.7 ± 11.1, respectively. Two patients with deep venous thrombosis and one patient with wound non-purulent exudate were noted. Additionally, the wounds healed after routine dressing change. No other complications, including skin necrosis or delayed, non-union or malunion, were observed. The new strategy combining DRTR with MIPO in the treatment of pilon fractures allowed excellent radiological and clinical outcomes and a low postoperative complication rate to be achieved in a short-term follow-up period. Further large sample and comparative studies should be conducted to validate our results.
本研究旨在介绍一种结合双反向牵引复位器（DRTR）和微创钢板接骨术（MIPO）治疗 Pilon 骨折的技术，并观察短期随访期间该方法的效果。2018 年 1 月至 12 月，回顾采用 MIPO 结合 DRTR 治疗的 Pilon 骨折患者。提取 24 例患者的人口统计学和骨折特征、手术数据和预后数据。所有 24 例患者均采用 MIPO 技术实现闭合复位，观察到良好的功能和影像学结果。手术时间和术中失血量的平均值分别为 95.0±14.2 分钟和 152.1±52.1 毫升。平均进行 16.0±1.9 次术中透视。在 12 个月的随访评估中，平均 AOFAS 评分为 85.2±5.1。23 例（95.8%）患者观察到解剖或良好复位。背屈和跖屈的平均活动范围分别为 11.0±2.7 和 32.7±11.1。2 例患者发生深静脉血栓形成，1 例患者出现伤口非脓性渗出物。此外，常规换药后伤口愈合。未观察到其他并发症，包括皮肤坏死或延迟、不愈合或畸形愈合。DRTR 与 MIPO 联合治疗 Pilon 骨折的新策略在短期随访期间可获得良好的影像学和临床效果，且术后并发症发生率较低。应进行进一步的大样本和对照研究来验证我们的结果。
