Single Anterolateral Incision for Pilon Fracture with Fibular Fracture
CHEN Jian-liang, XU Yong, YAO Guang-xiao.
Shangyu Hospital of Traditional Chinese Medicine, Shaoxing City, Shaoxing (312360), China
Abstract:
Objective To explore the feasibility of treating Pilon fracture with fibular fracture through a single anterolateral incision of the lower leg. Methods The patients of Pilon fracture with lower fibula fracture (33 cases) were selected and treated, all of which required open reduction and internal fixation with steel plate. Single blind test was used to randomly divide the patients into two groups, 17 cases in group A treated with traditional anterolateral incision and posterolateral incision for open reduction and internal fixation, and 16 cases in group B treated with single anterolateral incision for open reduction and internal fixation. The operation time was recorded, the wound healing was observed, and the curative effect was evaluated according to Mazur evaluation standard. Results No serious surgical complications such as exposure of steel plate and infection occurred in all patients. Among the 17 patients in group A, 4 had local skin necrosis after operation, 3 healed spontaneously within 2 weeks, and 1 healed after 3 weeks. According to Mazur scoring criteria, 11 cases were excellent, 5 cases were good and 1 case was fair. In group B, 16 patients underwent surgery, and 2 patients had local skin necrosis with small area, which healed by itself within 1 week. The curative effect was evaluated according to Mazur scoring standard, of which 10 cases were excellent, 4 cases were good and 2 cases were fair. The clinical efficacy and soft tissue recovery of the two groups were evaluated with good results, and the application of a single anterolateral incision did not increase the operation time compared with the traditional approach. Statistical analysis showed that there was no difference in the operation time and efficacy between the two groups. Conclusion Improved single incision on the anterolateral leg for Pilon fracture with fibular fracture can avoid further injury of local soft tissue.
