| Objective:We selected Riiedi-Allgower as Ⅱ-Ⅲ type Pilon fracture patients in the First Affiliated Hospital of Kunming Medical University through retrospective analysis from the year of 2012 to 2014. We explored the relationships between gender, age, injury mechanism, fracture type, timing of surgery, surgical approach, fracture reduction quality, postoperative complications and postoperative ankle function score, and to investigate the relationship between the degree of injury of articular surface of cartilage and the quality of fracture reduction and the long-term complications after operation.To improve for the treatment of severe Pilon fracture of surgical treatment in patients severely to provide clinical bases and references.Methods:Elaborate need to collect Pilon fracture patients with diagnostic criteria, inclusion criteria and exclusion criteria, by Kunming Medical University First Affiliated Hospital electronic retrieval system in 2012 January to December 2014 diagnosis for type Riiedi-Allgower as II and III conforms to the standard of Pilon fracture patients with disease duration, were collected from medical records of 48 points. A careful review of medical records and records of the patient’s gender, age, cause of injury, the date of injury and the date of operation, X-ray registration number, Preoperative CT scan and 3D reconstruction of ankle joint or MRI of ankle joint, operation mode, operation record,and postoperative complications were reviewed. Patients were followed up or informed by telephone follow-up, and the Mazur ankle function score was made. Classification of articular cartilage damage in the ankle according to MRI or surgical records,to analyze the relationship between the degree of cartilage injury and the quality of fracture reduction and the long-term complications after surgery,The collected data into the SPSS 17.0 Chinese database for statistical analysis. The dependent variable, the first single factor variance analysis (ANOVA) and the two samples were to use t test, As P value< 0.05 was considered statistically significant, The multivariate linear model was established by using the functional score of the ankle joint as the dependent variable.Results:The collection of 48 cases of patients were followed up and completed the whole process. All participants aged fron 18 to 65, and the year of them was 40.7 years old.35 were males, and the year of them was 40 years old, and the year of 13 females was 42 years old, male and female ratio was 2.7:1. Fracture classification:type II 27 cases, accounting for 56.2%; III type 21 cases, accounting for 43.8%. Mazur ankle function score:excellent rate of type Ⅱ 92.6%, type III excellent rate of 57.1%. Cartilage damage:grade 3,37 cases, grade 4,11 cases. Among them,2 cases of joint memory in free cartilage, to be taken out, after fracture healing of traumatic arthritis; 5 cases because of failure to anatomical reduction and passive movement of the ankle joint stiffness.Univariate analysis showed that:age, gender, injury and surgical timing and Mazur ankle joint function score differences had no statistical significance, the type of fracture (P=0.001<0.05), surgical approach (P=0.045<0.05), fracture reduction quality P=0<0.05 and Mazur ankle joint function score difference was statistically significant. The fracture type, operation, fracture reduction quality as the independent variable and Mazur ankle function score as dependent variable, the assignment by establishing multiple linear regression model, the final surgery, fracture reduction quality two independent variables selected into the equation, regression equation is: Y=55.293-2.941X1+13.408X3Conclusion:1 Preoperative and intraoperative assessment of articular cartilage injury of the ankle joint in Pilon fracture should be evaluated in detail, and the degree of cartilage injury is closely related to the occurrence of postoperative complications. Cartilage damage, cartilage surface repair and early postoperative functional exercise are the important factors to reduce the postoperative traumatic arthritis;2 For Ruedi-Allgower as Ⅱ～Ⅲ type Pilon fractures, fracture type, fracture reduction quality is and the factors influencing postoperative ankle function. |
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