切开复位内固定及有限内固定结合外固定治疗胫骨P订on骨折对比探究［摘要］目的比较切开复位内固定与有限内固定结合外固定治疗胫骨Pilon骨折的疗效。方法将76例经X线或CT证实的胫骨P订on骨折患者随机分为研究组(n=38,接受有限内固定结合外固定架治疗)和对照组(n=38,接受切开复位内固定术)，比较两组骨折愈合时间、患者术后踝关节功能恢复情况及并发症发生情况。结果研究组平均骨折愈合时间［(5.9±0.6)个月］较对照组［(5.2±0.4)个月］稍长，但差异无统计学意义(P>0.05)；两组患者术后踝关节功能均得到恢复，但研究组疗效优良率(84.21%)显著高于对照组(68.42%)(P<0.05)；研究组并发症发生率为15.79%(6/38),显著低于对照组的28.95%(11/38)(P<0.05),其中软组织感染发生率较对照组高(P<0.05),骨髓炎及骨折畸形愈合发生率较对照组低(P<0.05),关节融合发生率差异无统计学意义(P>0.05)o结论有限内固定结合外固定治疗胫骨P订on骨折操作简单、安全，并发症少，可获得较好的踝关节功能和预后，值得临床推广应用。［关键词］切开复位内固定；有限内固定结合外固定；P订on骨折；对比研究［中图分类号］R683.42［文献标识码］A［文章编号］1673-7210(2012)07(a)-0048-03ComparativestudyofopenreductionandinternalfixationversusexternalfixationcombinedwithlimitedinternalfixationinthetreatmentofPilonfracturesZHANGXiaobingNo.1DepartmentofOrthopedics,LangfangFourthHospitalofBazhouCity,HebeiProvince,Bazhou067500,China［Abstract］ObjectiveTocomparetheefficacyofopenreductionandinternalfixationversusexternalfixationcombinedwithlimitedinternalfixationinthetreatmentofPilonfractures・Methods76patientswithPilonfracturesconfirmedbyX-rayorCTweredividedintostudygroup(n=38,receivedexternalfixationcombinedwithlimitedinternalfixation)andcontrolgroup(n=38,receivedopenreductionandinternalfixation)atrandom,thefracturehealingtime,postoperativeanklejointfunctionrecoveryandcomplicationsofthetwogroupswerecompared・ResultsThemeanfracturehealingtimeofstudygroupwas(5.9±0.6)months,slightlylongerthancontrolgroupof(5.2+0.4)months,butnostatisticaldifferencewasobserved(P>0.05).Theanklejointfunctionofbothgroupswaswellrecovered,butthegoodrateofstudygroup(84.21%)wassignifiesntlyhigherthancontrolgroup(68.42%)(P<0.05).Thecomplicationincideneeofstudygroupwas15.79%(6/38),whichwasstatisticallyhigherthancontrolgroup[28.95%(11/38)](P<0.05),andtheincidenceofsofttissueinfectionwashigherthancontrolgroup(P<0.05),theincidencesofosteomyelitisandmalunionwerelowerthancontrolgroup(P<0.05),andtheincidencesofjointfusionwereequalintwogroups(P>0.05).ConclusionExternalfixationcombinedwithlimitedinternalfixationissimpleandsafewithlesscomplicationsintreatingPilonfractures,anditcamobtaingoodanklejointfunctionprognosis,thusitisworthyofextensiveappliedinclinic・[Keywords]Openreductionandinternalfixation；Externalfixationcombinedwithlimitedinternalfixation；Pilonfractures；Comparativestudy
