CAJ | 학술논문

目的：比较分步延期切开复位内固定和有限切开支架外固定治疗高能量Pilon骨折的临床疗效。方法回顾性分析2010年1月～2013年1月间通过分步延期切开复位内固定和有限切开支架外固定所治疗的的Ⅱ、Ⅲ型 Pilon骨折62例，按配对设计方法为分步延期切开复位内固组31例和有限切开支架外固定组31例。两组手术由同一组医生完成。治疗效果评价采用Burwell-charnley 的Pilon 骨折放射学评价标准和Mazur 踝关节症状与功能评分标准进行评价。结果所有患者均获随访，随访时间10～20个月，平均为12个月。术后随访X片显示，两组间Burwell-charnley评分无明显差异，随访发现两组间Mazur 踝关节症状与功能评分无明显统计学差异，且两组间术后并发症差别无异，但有限切开支架外固定组手术时间和术中出血量均少于分步延期切开复位内固定组。结论对于Pilon 骨折，分步延期切开复位内固定方法和有限切开支架外固定均可取得满意疗效，但后者具有手术时间短、出血少等优点。
목적：비교분보연기절개복위내고정화유한절개지가외고정치료고능량Pilon골절적림상료효。방법회고성분석2010년1월～2013년1월간통과분보연기절개복위내고정화유한절개지가외고정소치료적적Ⅱ、Ⅲ형 Pilon골절62례，안배대설계방법위분보연기절개복위내고조31례화유한절개지가외고정조31례。량조수술유동일조의생완성。치료효과평개채용Burwell-charnley 적Pilon 골절방사학평개표준화Mazur 과관절증상여공능평분표준진행평개。결과소유환자균획수방，수방시간10～20개월，평균위12개월。술후수방X편현시，량조간Burwell-charnley평분무명현차이，수방발현량조간Mazur 과관절증상여공능평분무명현통계학차이，차량조간술후병발증차별무이，단유한절개지가외고정조수술시간화술중출혈량균소우분보연기절개복위내고정조。결론대우Pilon 골절，분보연기절개복위내고정방법화유한절개지가외고정균가취득만의료효，단후자구유수술시간단、출혈소등우점。
Objective To compare the clinical efficacy of methods in treatment of severe Pilon fracture with two-stage open reduction and internal fixation(ORIF) and limited internal fixation external fixation.MethodsThe surgical treatmen patients from January 2010 to January 2011 formed a retrospective comparative study. 31 cases of severe Pilon fracture patients who using two-stage ORIF added to two-stage ORIF group and 31 cases patients who using limited internal fixation external fixation added to the limited internal fixation external fixation group. The Burwell-Charnley radiological evaluation criteria and Mazur ankle function score were used to assess the clinical efficacy.Results All cases were followed up for 12-20months, with an average of 12 months. Burwell-Charnley radiological evaluation criteria and Mazur ankle function score between the two groups without significant difference. Both to achieve good therapeutic effect, but the the limited internal fixation external fixation group show intraoperative blood loss, operating time are significantly reduced. Conclusion Compared with the two-stage ORIF group,the limited internal fixation external fixation group can obtain the same effect, and has the advantage of intraoperative blood loss and operating time. Therefore, under the premise of the strict indications is worth in the clinical application.