临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
Journal of Clinical and Experimental Medicine
2015年
19期
1622-1624,1625
,共4页
高能量%Pilon%骨折%延期有限内固定%外固定支架%关节功能
高能量%Pilon%骨摺%延期有限內固定%外固定支架%關節功能
고능량%Pilon%골절%연기유한내고정%외고정지가%관절공능
High energy Pilon fracture%Delayed limited internal fixation%External fixation support%Joint function
目的：分析延期有限内固定结合外固定支架对高能量 Pilon 骨折患者关节功能与软组织损伤的影响。方法选择高能量 Pilon 骨折患者92例作为研究对象，采用随机数字表法分为接受急诊切开复位内固定治疗的对照组、接受延期有限内固定结合外固定支架治疗的观察组。比较两组患者的关节功能、软组织损伤程度及术后并发症等情况。结果观察组治疗后4个月、8个月、12个月 Kofoed 评分及 Baird 踝关节评分均明显高于对照组（82.18±7.33 vs.70.92±6.72，89.17±8.05 vs.78.62±9.62，95.28±3.21 vs.83.16±5.39；86.12±7.05 vs.73.38±8.31，91.62±5.38 vs.79.71±7.33，96.36±3.82 vs.83.91±8.17）；轻度及重度软组织损伤、伤口浅表感染及骨折愈合延迟等均明显低于对照组（26.09% vs.67.39%，10.87% vs.32.61%，8.69% vs.23.91%，6.52% vs.28.26%）。结论延期有限内固定结合外固定支架治疗可以提高高能量Pilon 骨折患者的术后踝关节功能、减少软组织损伤及并发症发生。
目的：分析延期有限內固定結閤外固定支架對高能量 Pilon 骨摺患者關節功能與軟組織損傷的影響。方法選擇高能量 Pilon 骨摺患者92例作為研究對象，採用隨機數字錶法分為接受急診切開複位內固定治療的對照組、接受延期有限內固定結閤外固定支架治療的觀察組。比較兩組患者的關節功能、軟組織損傷程度及術後併髮癥等情況。結果觀察組治療後4箇月、8箇月、12箇月 Kofoed 評分及 Baird 踝關節評分均明顯高于對照組（82.18±7.33 vs.70.92±6.72，89.17±8.05 vs.78.62±9.62，95.28±3.21 vs.83.16±5.39；86.12±7.05 vs.73.38±8.31，91.62±5.38 vs.79.71±7.33，96.36±3.82 vs.83.91±8.17）；輕度及重度軟組織損傷、傷口淺錶感染及骨摺愈閤延遲等均明顯低于對照組（26.09% vs.67.39%，10.87% vs.32.61%，8.69% vs.23.91%，6.52% vs.28.26%）。結論延期有限內固定結閤外固定支架治療可以提高高能量Pilon 骨摺患者的術後踝關節功能、減少軟組織損傷及併髮癥髮生。
목적：분석연기유한내고정결합외고정지가대고능량 Pilon 골절환자관절공능여연조직손상적영향。방법선택고능량 Pilon 골절환자92례작위연구대상，채용수궤수자표법분위접수급진절개복위내고정치료적대조조、접수연기유한내고정결합외고정지가치료적관찰조。비교량조환자적관절공능、연조직손상정도급술후병발증등정황。결과관찰조치료후4개월、8개월、12개월 Kofoed 평분급 Baird 과관절평분균명현고우대조조（82.18±7.33 vs.70.92±6.72，89.17±8.05 vs.78.62±9.62，95.28±3.21 vs.83.16±5.39；86.12±7.05 vs.73.38±8.31，91.62±5.38 vs.79.71±7.33，96.36±3.82 vs.83.91±8.17）；경도급중도연조직손상、상구천표감염급골절유합연지등균명현저우대조조（26.09% vs.67.39%，10.87% vs.32.61%，8.69% vs.23.91%，6.52% vs.28.26%）。결론연기유한내고정결합외고정지가치료가이제고고능량Pilon 골절환자적술후과관절공능、감소연조직손상급병발증발생。
Objective To analyze the effect of delayed limited internal fixation combined external fixation in support of joint function and soft tissue injuries in patients with high energy Pilon fractures. Methods A total of 92 patients with high energy Pilon fractures in this hospital were allocated in this study,they were randomly divided into observation group and control group,patients in control group were given with emer-gent open reduction and patients in observation group received delayed limited internal fixation combined external fixation for support of joint func-tion,degree of soft tissue injury and postoperative complications were compared between these 2 groups. Results After treatment for 4 months, eight months and 12 months,the Kofoed scores and Baird scores in observation group were significantly higher than those of control group(82. 18 ± 7. 33 vs. 70. 92 ± 6. 72,89. 17 ± 8. 05 vs. 78. 62 ± 9. 62,95. 28 ± 3. 21 vs. 83. 16 ± 5. 39;86. 12 ± 7. 05 vs. 73. 38 ± 8. 31,91. 62 ± 5. 38 vs. 79. 71 ± 7. 33,96. 36 ± 3. 82 vs. 83. 91 ± 8. 17). Mild and severe soft tissue injuries,postoperative superficial wound infection and healing delay of fracture were significantly lower than those of control group(26. 09% vs. 67. 39% ,10. 87% vs. 32. 61% ,8. 69% vs. 23. 91% ,6. 52%vs. 28. 26% ). Conclusion The application of delayed limited internal fixation combined external fixation support therapy can improve the postop-erative ankle function,and reduce soft tissue injuries and complications in patients with high energy Pilon fractures.
