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| Comparison of the effect of two different surgical methods in treatment of Rüedi-Allg?觟ver Ⅲ closed Pilon fractures with fibula fractures |
| LUO Yuancheng WANG Jing▲ YANG Wei WU Meiping ZHU Bin WANG Lizuo AO Chuanxi |
| Department of Orthopaedics and Traumatology, the National Hospital of Enshi Tujia and Miao Autonomous Prefecture, Hubei Province, Enshi 445000, China |
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Abstract Objective To compare the clinical efficacy of staging operation internal fixation and one stage operation internal fixation in treatment of Rüedi-Allg?觟ver Ⅲ closed Pilon fractures with fibula fractures. Methods From January 2014 to December 2017, the clinical data of 61 patients with Rüedi-Allg?觟ver Ⅲ closed Pilon fractures with fibula fractures hospitalized in the Department of Orthopaedics and Traumatology, National Hospital of Enshi Autonomous Prefecture were analyzed retrospectively. According to the different treatment methods, they were divided into 29 cases in the treatment group and 32 cases in the control group. In the treatment group, internal fixation was performed by stages, fibula was fixed at stage one, tibia was fixed at stage two. The control group received simultaneous surgical internal fixation, and the tibia and fibula were fixed in one operation. Patients in both groups were followed up for 12 months. Length of stay, cost, complications, fracture healing and ankle function recovery were compared between the two groups. Results At 12 months follow-up, most of the fractures in both groups were completely healed. There was no statistically significant difference in length of stay between the two groups (P ＞ 0.05). The cost of treatment group was higher than that of the control group, the incidence of complications was lower than that of the control group, and the American orthopaedic foot and ankle society (AOFAS) score at the last follow-up was higher than that of the control group, with statistically significant differences (all P ＜ 0.05). The differences between the two groups at time points and between the two groups were statistically significant (all P ＜ 0.05), indicating that the Lane-Sandhu score had a trend of changing with time, and the grouping factors could play a role. There was no statistically significant difference in the interaction between the two groups (P ＞ 0.05), indicating that the effect of time factor was not affected by the grouping factor. Compared with this group 1 month after the operation, the Lane-Sandhu score in the two groups increased at 3 months and 6 months after operation, and the Lane-Sandhu score at 6 months after operation was higher than that at 3 months after operation, the difference was statistically significant (all P ＜ 0.05). Lane-Sandhu score in the treatment group was higher than that in the control group at 3 and 6 months after operation, with statistically significant differences (P ＜ 0.05). Conclusion Staging operation in the treatment of Rüedi-Allgöver Ⅲ closed Pilon fractures with fibula fractures has higher safety, rapid fracture healing, greater functional recovery. It is worthy to spread in clinic.
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