急诊与择期手术治疗Pilon骨折的比较

贾光辉; 王天旭; 李兴华; 王金堂; 李萌; 张智

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急诊与择期手术治疗Pilon骨折的比较

贾光辉 , 王天旭 , 李兴华 , 王金堂 , 李萌 , 张智

文章导航 > 蚌埠医学院学报 > 2013, 37 > 4: (418-420)

引用本文:

Citation:

急诊与择期手术治疗Pilon骨折的比较

1.
1. 河南省郑州市骨科医院下肢科, 450013;
2.
2. 西安交通大学第一附属医院骨科, 陕西西安 710061

作者简介: 贾光辉(1979－ ),男,主治医师.

基金项目:

The comparative study of emergency and selective operation in the treatment of Pilon fracture

1.
1. Department of Lower Limb, The Orthopaedic Hospital of Zhengzhou, Zhengzhou He′nan 450013;
2.
2. Department of Orthopedics, The First Affiliated Hospital of Medical College of Xi′an Jiaotong University, Xi′an Shanxi 710061, China

摘要: 目的:比较急诊与择期手术治疗Pilon骨折的临床效果,为临床治疗方式的选择提供参考。方法:选择2005年2月至2011年3月采用急诊及择期手术治疗的Pilon骨折患者138例,将伤后12 h内手术的患者视为急诊手术组,共49例;受伤7 d后手术视为择期手术组,共89例。对2组患者手术时间(以止血带充气加压时间计算)、出血量、住院时间、住院费用、术后并发症、踝关节功能康复情况进行比较分析。结果:随访9～36个月。急诊手术组手术时间明显少于择期手术组,而术中出血量明显多于择期手术组(P0.01);急诊手术组的住院时间明显短于择期手术组(P0.01),且住院费用前者较后者为少(P0.01);2组术后伤口感染坏死、下肢深静脉血栓形成及远期并发症如骨折延迟愈合或不愈合、骨性关节炎和踝关节僵硬发生率差异均无统计学意义(P0.05);2组术后22个月踝关节功能Mazur评分分级差异无统计学意义(P0.05)。结论:采用急诊手术治疗Pilon骨折,较择期手术并没有更高的术后并发症发生率,相反急诊手术可缩短住院时间,减少住院费用,有利于早期功能康复。
- Pilon骨折 /
- 择期手术 /
- 急诊手术
Abstract: Objective:To compare the clinical efficacy of emergency and selective operation in the treatment of Pilon fracture for providing the basis of clinical operation.Methods:One hundred and thirty-eight patients with Pilon fractures were treated with emergency or selective operation from Feb.2005 to Mar.2011.Fourty-nine patients were treated with emergency operation within 12 hours after injury,89 patients were treated with selective operation at 7 days after injury.The operation time,blood loss,length of stay,hospitalization expense,postoperative complication,ankle jiont functional recovery of two groups were compared.Results:All patients were followed up for 9 to 36 months.The operation time,length of stay and hospitalization expense in emergency operation group were significantly less than those in selective operation group(P0.01),but its blood loss was more.There were not statistically significant differences in wound infection and necrosis,lower limb deep vein thrombus,the long-term complications(such as nonunion or delayed union of fracture),osteoarthritis and the incidence of ankle joint stiffness between the two groups(P0.05).The Mazur scores of ankle joint function in two groups had no statistically significant difference in 22 months after operation(P0.05).Conclusions:The postoperative complication incidence of emergency operation in the treatment of Pilon fracture is not higher than that in selective operation,which can shorten the length of stay,decrease the hospitalization expense and promote early functional rehabilitation.
- Pilon fracture /
- selective operation /
- emergency operation

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急诊与择期手术治疗Pilon骨折的比较

作者简介: 贾光辉(1979－ ),男,主治医师.

1. 1. 河南省郑州市骨科医院下肢科, 450013;
2. 2. 西安交通大学第一附属医院骨科, 陕西西安 710061

收稿日期: 2012-07-10
网络出版日期: 2013-04-15

基金项目:

关键词:

摘要: 目的:比较急诊与择期手术治疗Pilon骨折的临床效果,为临床治疗方式的选择提供参考。方法:选择2005年2月至2011年3月采用急诊及择期手术治疗的Pilon骨折患者138例,将伤后12 h内手术的患者视为急诊手术组,共49例;受伤7 d后手术视为择期手术组,共89例。对2组患者手术时间(以止血带充气加压时间计算)、出血量、住院时间、住院费用、术后并发症、踝关节功能康复情况进行比较分析。结果:随访9～36个月。急诊手术组手术时间明显少于择期手术组,而术中出血量明显多于择期手术组(P0.01);急诊手术组的住院时间明显短于择期手术组(P0.01),且住院费用前者较后者为少(P0.01);2组术后伤口感染坏死、下肢深静脉血栓形成及远期并发症如骨折延迟愈合或不愈合、骨性关节炎和踝关节僵硬发生率差异均无统计学意义(P0.05);2组术后22个月踝关节功能Mazur评分分级差异无统计学意义(P0.05)。结论:采用急诊手术治疗Pilon骨折,较择期手术并没有更高的术后并发症发生率,相反急诊手术可缩短住院时间,减少住院费用,有利于早期功能康复。

English Abstract

The comparative study of emergency and selective operation in the treatment of Pilon fracture

1. 1. Department of Lower Limb, The Orthopaedic Hospital of Zhengzhou, Zhengzhou He′nan 450013;
2. 2. Department of Orthopedics, The First Affiliated Hospital of Medical College of Xi′an Jiaotong University, Xi′an Shanxi 710061, China

Received Date: 2012-07-10
Available Online: 2013-04-15

Abstract: Objective:To compare the clinical efficacy of emergency and selective operation in the treatment of Pilon fracture for providing the basis of clinical operation.Methods:One hundred and thirty-eight patients with Pilon fractures were treated with emergency or selective operation from Feb.2005 to Mar.2011.Fourty-nine patients were treated with emergency operation within 12 hours after injury,89 patients were treated with selective operation at 7 days after injury.The operation time,blood loss,length of stay,hospitalization expense,postoperative complication,ankle jiont functional recovery of two groups were compared.Results:All patients were followed up for 9 to 36 months.The operation time,length of stay and hospitalization expense in emergency operation group were significantly less than those in selective operation group(P0.01),but its blood loss was more.There were not statistically significant differences in wound infection and necrosis,lower limb deep vein thrombus,the long-term complications(such as nonunion or delayed union of fracture),osteoarthritis and the incidence of ankle joint stiffness between the two groups(P0.05).The Mazur scores of ankle joint function in two groups had no statistically significant difference in 22 months after operation(P0.05).Conclusions:The postoperative complication incidence of emergency operation in the treatment of Pilon fracture is not higher than that in selective operation,which can shorten the length of stay,decrease the hospitalization expense and promote early functional rehabilitation.