Abstract Objective To explore the clinical effect of extended modified posteromedial approach and posterolateral approach for open reduction and internal fixation of Pilon fractures. Methods A total of 84 patients with posterior Pilon fracture admitted to Suqian First People’s Hospital from May 2018 to May 2021 were selected and they were divided into the extended modified posterior medial approach group (42 cases) and the posterior lateral approach group (42 cases) according to the random number table method. The operation time, intraoperative blood loss, hospitalization time, weight-bearing time, fracture healing time, American Foot and Ankle Surgery Association (AOFAS) ankle-hindfoot score, visual analog scale (VAS) score, ankle range of motion, Burrwell-Charnley radiology score, and complication rates were compared in both groups. Results The amount of intraoperative bleeding in the extending the modified posterolateral approach group was less than that in the extending the modified posterolateral approach group(P＜0.05), and the hospitalization time, weight bearing time, and fracture healing time in the extending the modified posterolateral approach group were shorter than those in the extending the modified posterolateral approach group (P＜0.05); at six months after operation, the AOFAS scores of the two groups were higher those at three months after operation, and the prolonged modified posteromedial approach group were higher than the posterolateral approach group (P＜0.05); at six months after operation, the VAS scores in both groups were lower than those at three months after operation, and the extended modified posteromedial approach group was lower than that in the posterolateral approach group (P＜0.05). At six months after operation, the range of motion of ankle dorsiflexion and plantar flexion in both groups were higher than those at three months after operation, and the extended and modified posteromedial approach group was higher than the posterolateral approach group (P＜0.05). The excellent and good rate of the extended and modified posteromedial approach group was higher than that of the posterolateral approach group (P＜0.05). There was no significant difference in the incidence of complications between the two groups (P＞0.05). Conclusion Compared with the posterolateral approach, extending the modified posteromedial approach can accelerate fracture healing, improve ankle function, relieve postoperative pain, and improve fracture healing, which is safe and reliable.
LIU Xiangzhong JIANG Lüetao DENG Jielin▲. Clinical effect of extended modified posteromedial approach and posterolateral approach for open reduction and internal fixation of Pilon fractures[J]. 中国医药导报, 2023, 20(15): 90-94.
