Comparison of locking compression plate and anatomic plate internal fixation for Pilon fracture

doi:10.3969/j.issn.2095-4344.2015.13.023

Abstract

Abstract:

BACKGROUND: As a conventional internal fixation method, anatomic plate has some shortcomings. Recently locking plate has been widely used in treatment of Pilon fracture. How to effective reconstruct articular facet at the distal tibia and to reduce soft tissue damage have attracted increasing attentions.
OBJECTIVE: To compare the curative effect of locking compression plate versus anatomic plate internal fixation in treatment of Pilon fracture.
METHODS: A retrospective analysis was performed among 72 patients of Ruedi-Allgower II and III Pilon fracture, who were selected from Sanshui People’s Hospital of Foshan between January 2010 and August 2014. The involved patients were randomly divided into two groups: 36 patients of observation group were treated with locking compression plate internal fixation, and 36 patients of control group were given anatomic plate internal
fixation. The average operation time, postoperative recovery time, postoperative complications, curative effect and postoperative fracture situation were compared between the two groups.
RESULTS AND CONCLUSION: The average operation time and the average postoperative recovery time of observation group were significantly better than that of control group (P < 0.05). In terms of postoperative complications, there were less cases of delayed healing and non-union in the observation group than in the control group. 26 cases of observation group and 22 cases of control group recovered well after internal fixation, observation group was better than control group. There was no significant difference in the radiological evaluation results of postoperative recovery between the two groups (P > 0.05). Compared with the anatomic plate internal fixation, locking compression plate internal fixation can shorten the operation time and postoperative recovery time, reduce the incidence of delayed healing and nonunion after internal fixation, and improve clinical curative effect in treatment of Pilon fracture.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: Tibia, Fractures, Bone, Fracture Healing, Internal Fixators

CLC Number:

R318

Wang Bin, Wang Zhi-zhong, Zhang Fan. Comparison of locking compression plate and anatomic plate internal fixation for Pilon fracture[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(13): 2091-2095.

Figures/Tables 2

2.1 参与者数量分析按意向性处理，纳入Ruedi- Allgower Ⅱ、Ⅲ型Pilon骨折患者72例，随机分为两组，观察组及对照组各36例，全部进入结果分析，无脱落。两组分组流程图见图1。 2.2 临床资料比较观察组与对照组患者年龄、性别等一般资料间差异无显著性意义(P > 0.05)，具有可比性，见表1。 2.3 两组患者预后指标比较从统计结果来看，平均手术时间、平均术后恢复时间采用锁定加压钢板内固定治疗的观察组患者优于采用解剖钢板内固定治疗的对照组，差异有显著性意义(P < 0.05)；在术后并发症方面，观察组在延迟愈合与不愈合发生率为0，对照组则分别发生2例和3例，尽管差异无显著性意义，两者比较差异仍较鲜明，且统计发现无论是锁定加压钢板内固定还是解剖钢板内固定均会发生感染现象，且骨不连、畸形愈合等并发症的发生率两组差异也无显著性意义(P > 0.05)，见表2。 2.4 两组患者修复效果比较本次试验72例患者均未失访，随访时间10-24个月。结果显示观察组术后恢复优者26例，其中Ⅱ型17例，Ⅲ型9例；对照组术后恢复优者22例，其中Ⅱ型15例，Ⅲ型7例，两组比较观察组优于对照组，尽管差异无显著性意义，两者比较差异仍较鲜明；而两组患者中恢复至良、可、差的例数差异不大，且差异无显著性意义(P > 0.05)，见表3。 2.5 两组患者术后骨折复位情况比较统计结果显示，对于患者术后恢复的放射学评价结果，采用锁定加压钢板内固定治疗的观察组患者与采用解剖钢板内固定治疗的对照组患者的解剖复位分别为17例和15例，复位可分别为15例和16例，复位差分别为4例和5例，两组差异均无显著性意义(P > 0.05)，见表4。 2.6 不良事件两种内固定修复Pilon骨折虽可确保皮肤软组织血液循环安全，避免手术切口皮肤软组织坏死、感染， "

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