曹晓东

[摘要] 目的 分析切开复位内固定联合负压封闭引流治疗胫骨开放性Pilon骨折的疗效。方法 方便选择该院自2013年1月—2017年7月收治的70例胫骨开放性Pilon骨折患者将其随机分为2组，对照组和观察组，每组35例。对照组患者给予切开复位内固定术，观察组给予切开复位内固定联合负压封闭引流，对比两组患者治疗效果。结果 观察组患者优良率为94.26%明显高于对照组71.43%，相对比，差异有统计学意义（P<0.05）。观察组皮瓣愈合率、骨折愈合率分别为91.43%、94.26%均明显高于对照组82.86%、80.00%，相对比，差异有统计学意义（P<0.05）。观察组患者并发症发生率为5.71%明显低于对照组22.86%，相对比，差异有统计学意义（P<0.05）。结论 要提高胫骨Pilon骨折患者的皮瓣、骨折愈合率，减少并发症的发生，可采用切开复位内固定联合负压封闭引流治疗。

[关键词] 切开复位内固定；负压封闭引流；胫骨开放性Pilon骨折

[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742（2018）01（a）-0095-03

Therapeutic Effect of Open Reduction and Internal Fixation Combined with Negative Pressure Occlusion on Tibial Open Pilon Fracture

CAO Xiao-dong

Department of Orthopedics， Taicang Hospital Affiliated to Suzhou University（Taicang First Peoples Hospital）， Taicang， Jiangsu Province， 215400 China

[Abstract] Objective This paper tries to study the effect of open reduction and internal fixation combined with negative pressure occlusion on tibial open Pilon fracture. Methods 70 patients with open tibial fractures from January 2013 to July 2017 were convenient selected and randomly divided into two groups： control group and observation group， with 35 patients in each group. The patients in the control group were treated with open reduction and internal fixation. The observation group was treated with open reduction and internal fixation combined with negative pressure and drainage. The treatment effect was compared between the two groups. Results The excellent and good rate of the observation group was 94.26%， which was significantly higher than that of the control group 71.43%（P<0.05）. The healing rate of flap and the healing rate were 91.43% and 94.26%， respectively， which were significantly higher than those in the control group 82.86%， 80.00%（P<0.05）. The incidence of complications in the observation group was 5.71%， which was significantly lower than that in the control group （22.86%，P<0.05）. Conclusion The open the internal fixation combined with negative pressure closed drainage treatment can be used to improve the tibial Pilon fracture in patients with flap， fracture healing rate， reduce the incidence of complications.

[Key words] Open reduction internal fixation； Negative pressure closed drainage； Tibial open Pilon fracture

脛骨开放性Pilon骨折有一定的治疗难度，因发生该骨折后周围组织多有累及，出现损伤的情况。在临床多采用切开复位内固定术进行治疗，该治疗方法有较好的复位、固定效果，但在固定时需植入钢板及螺钉，创口感染的机率较大，联合负压封闭引流治疗，可减少二次损伤，还能彻底引出创面渗出物，利于术后恢复等优势[1-2]，现方便选择该院自2013年1月—2017年7月收治的70例胫骨开放性Pilon骨折患者作为研究对象，现报道如下。

1 资料与方法

1.1 一般资料

方便选择该院收治的70例胫骨开放性Pilon骨折患者将其随机分为2组，对照组和观察组，每组35例。对照组，男18例，女17例，年龄为20～65岁，平均年龄为（42.33±21.76）岁。骨折原因：16例（45.71%）为车祸，9例（25.71%）为高空坠落伤，6例（17.14%）为运动伤，4例（11.43%）为打击伤。观察组，男19例，女16例，年龄为21～64岁，平均年龄为（42.47±21.07）岁。骨折原因：17例（48.57%）为车祸，10例（28.57%）为高空坠落伤，5例（14.29%）为运动伤，3例（8.57%）为打击伤。这两组患者在一般资料等动方面差异无统计学意义（P>0.05）。……