CAJ | 학술논문

目的：研究两种手术入路治疗Topliss分型闭合矢状面Pilon骨折的临床疗效对比。方法随机选取2010年2月-2013年2月期间，闭合矢状面Pilon骨折的患者60例，随机进行分组，所有患者均采用切开复位钢板支持内固定手术，其中A组30例患者，采用Topliss分型下的前外侧入路进行治疗，B组30例患者，采用Topliss分型下的后内侧入路进行治疗。观察并统计两组患者临床治疗效果，以手术时间、手术出血量、住院时间、手术后并发症的发生率、Mazur踝关节功能评分以及骨折的复位愈合程度等作为该次研究评定标准。结果通过分析得知，A组患者手术时间(190.1±20.31)min，手术出血量(220.46±28.98)mL，B组患者手术时间(198.3±24.56)min，手术出血量(230.52±34.68)mL，两组比较差异无统计学意义(P>0.05)，但是A组患者在住院时间(20.34±3.45)d和手术后并发症的发生率10.1%却明显的优于B组患者住院时间住院时间(28.56±5.21)d以及并发症发生率4.35%差异有统计学意义(P<0.05)，A组患者和B组患者的Mazur踝关节功能评分以及骨折的复位愈合程度等方面差异无统计学意义(P>0.05)。结论通过此次研究得出，前外侧入路进行治疗不仅能缩短患者的住院时间，而且还能减少并发症的发生率，在临床上具有重要的指导意义。
목적：연구량충수술입로치료Topliss분형폐합시상면Pilon골절적림상료효대비。방법수궤선취2010년2월-2013년2월기간，폐합시상면Pilon골절적환자60례，수궤진행분조，소유환자균채용절개복위강판지지내고정수술，기중A조30례환자，채용Topliss분형하적전외측입로진행치료，B조30례환자，채용Topliss분형하적후내측입로진행치료。관찰병통계량조환자림상치료효과，이수술시간、수술출혈량、주원시간、수술후병발증적발생솔、Mazur과관절공능평분이급골절적복위유합정도등작위해차연구평정표준。결과통과분석득지，A조환자수술시간(190.1±20.31)min，수술출혈량(220.46±28.98)mL，B조환자수술시간(198.3±24.56)min，수술출혈량(230.52±34.68)mL，량조비교차이무통계학의의(P>0.05)，단시A조환자재주원시간(20.34±3.45)d화수술후병발증적발생솔10.1%각명현적우우B조환자주원시간주원시간(28.56±5.21)d이급병발증발생솔4.35%차이유통계학의의(P<0.05)，A조환자화B조환자적Mazur과관절공능평분이급골절적복위유합정도등방면차이무통계학의의(P>0.05)。결론통과차차연구득출，전외측입로진행치료불부능축단환자적주원시간，이차환능감소병발증적발생솔，재림상상구유중요적지도의의。
Objective To compare the effect of two kinds of surgical approaches for the treatment of topliss closed sagittal pilon fractures. Methods 60 patients with topliss closed sagittal pilon fractures who were treated with open reduction and internal fixa-tion with buttress plates between Februry 2010 and Februry 2013 were selected and divided randomly into group A (n=30) and group B (n=30).Patients in group A were treated by the anterolateral approach, while those in group B were treated by the postero-medial approach. Operation time, bleeding volume during operation, hospitalization time, the incidence of postoperative complica-tions, Mazur ankle function score , fracture healing and reduction degree were considered as the evaluation standard. Clinical treatment effects of the two groups were observed and recorded.Results The analysis showed that the A group of patients with oper-ation time (190.1±20.31) min, the amount of hemorrhage (220.46±28.98) ml, B group of patients with operation time (198.3±24.56) min, the amount of hemorrhage (230.52±34.68) mL, difference between the two groups was not significant, but the patients in the A group the time of hospitalization (20.34± 3.45) d and the incidence of postoperative complications of 10.1% is obviously superior to group B in hospitalized patients hospitalization time (28.56±5.21) d and the complication rate was 4.35%, with statis-tical significance of P<0.05, no significant difference between Mazur ankle function in patients of group A and group B scores of patients and the reduction degree of fracture healingand other aspects, P>0.05 no statistical significance. Conclusion The study shows that the anterolateral approach for treatment can not only shorten the hospitalization time of patients, but also reduce the in-cidence of complications, and has important guiding significance in clinical application.