经胫前外侧入路切口在治疗Pilon骨折中的应用

目的探讨经胫前外侧入路治疗Pilon骨折的临床疗效。方法将Pilon骨折病人28例随机分为胫前外侧入路组（A组）与传统内外侧入路组（B组），每组14例。随访并分析比较病人切口长度、手术时间、术中出血量、术后引流量、骨折愈合时间、骨折复位情况、术后并发症情况、术后踝关节功能等指标以评价疗效。结果2组病人解剖复位率、手术时间、骨折愈合时间差异均无统计学意义（P>0.05）；但A组切口长度明显短于B组，术中出血、术后引流量均明显低于B组（P < 0.01）。2组病人关节功能优良率及并发症发生率差异均无统计学意义（P>0.05）；但A组病人Barid-Jackson评分明显高于B组（P < 0.01）。结论经胫前外侧入路治疗关节面内侧严重粉碎塌陷以外类型的Pilon骨折，能取得满意的疗效，优于传统内外侧入路，可促进病人尽快康复。

Application value of the anterolateral tibial approach in the treatment of Pilon fracture

ObjectiveTo evaluate the clinical effects of the anterolateral tibial approach in the treatment of Pilon fracture.MethodsA total of 28 patients with Pilon fracture were randomly divided into the anterior lateral approach group(group A) and traditional medial approach group(group B)(14 cases each group).The incision length, operation time, intraoperative blood loss, postoperative drainage, fracture healing time, fracture reduction, postoperative complications and postoperative ankle function between two groups were compared.ResultsThe differences of the anatomical reduction rate, operation time and fracture healing time between two groups were not statistically significant(P>0.05).The incision length in group A was significantly shorter than that in group B, and the intraoperative bleeding and postoperative drainage volume in group A were significantly lower than those in group B(P < 0.01).The differences of the excellent rate of joint function and incidence rate of complications between two groups were not statistically significant(P>0.05).The Barid-Jackson score in group A was significantly higher than that in group B(P < 0.01).ConclusionsThe anterolateral tibial approach in the treatment of Pilon fracture except to severe crushing and collapse of the inner side of the articular surface can achieve satisfactory efficacy and promote the patients to recover as soon as possible, which is superior to the traditional medial and lateral approach.