Clinical Retrospective Analysis Of Open Reduction And Internal Fixation For Treatment Of Tibial Pilon Fracture

objective The sacral Pilon fracture is one of the most difficult points in the clinical treatment of orthopedics.The emergency treatment is often treated with open reduction and internal fixation.However,due to the lack of soft tissue coverage in the middle and lower part of the humerus,the surgical treatment will aggravate and affect the blood supply at the fracture end.Complications such as healing and loosening of internal fixation materials seriously affect the postoperative rehabilitation and quality of life of patients.At this stage,with the continuous advancement of medical technology,the clinical concept of step-by-step surgery has been proposed.It is believed that the traction therapy can promote the improvement of local soft tissue and blood supply,which can create favorable conditions for the next surgical treatment.In this study,comparative analysis,literature review,and data analysis were used to analyze the data of 60 patients with iliac Pilon fractures,and to observe the effect of early open reduction and internal fixation and step-delay surgery.The aim is to provide a theoretical reference for the clinical treatment of tibia Pilon fractures.method 60 patients with tibia Pilon fractures who were admitted to our hospital from July 2016 to February 2018 were selected as subjects.All of them met the inclusion and exclusion criteria.The control group was treated with early open reduction and internal fixation.The operation time was determined 3-24 hours after the injury.The observation group was treated with step-delayed surgery.Specific circumstances give traction,anti-infection,temporary fixation and other symptomatic intervention,the operation time is generally 7-15 d after injury.Among them,30 cases were divided into the control group and the observation group.The effects of surgical treatment,operation time,intraoperative blood loss,fracture healing time,complication rate,and ankle function recovery were compared between the two groups.result(1)The operation time of the observation group was(67.81±8.62)min,the intraoperative blood loss was(39.82±8.13)ml;the operation time of the control group was(91.55±10.63)min,and the intraoperative blood loss was(81.39±12.57)ml..The operation time of the observation group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group.The difference was statistically significant(P<0.05).(2)Mazur(1979)ankle joint evaluation grading system was used to evaluate the surgical results.The total effective rate of the control group was 70.00%,and the total effective rate of the observation group was 93.33%.The total effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).(3)After the patient's condition was analyzed reasonably,no nonunion and osteomyelitis occurred in the two groups after systemic treatment.In addition,the incidence of skin necrosis,incision dehiscence,delayed fracture healing,soft tissue infection,traumatic joint,and joint stiffness were not statistically significant(P>0.05).All complications were effective after symptomatic intervention.improve.(4)The fracture healing time of the observation group was(115.14±14.32)d,which was significantly shorter than that of the control group(184.37±13.28)d,and the difference was statistically significant(P<0.05).(5)At 3 months after operation,the excellent and good rates of ankle function recovery were 83.33% and 90.00% respectively in the observation group,which were significantly higher than those in the control group(63.33%,66.67%,P < 0.05).conclusion Both surgical methods have their own characteristics in the treatment of tibia Pilon fractures,which can play a role in fixing the fracture end,keeping the articular surface flat and reducing complications.In contrast,step-by-step extended surgery has the advantages of “shorting time and less intraoperative blood loss”,which can reduce the risk of surgery.In addition,step-by-step extended surgery can effectively reduce the incidence of soft tissue complications caused by the "hysteresis" of soft tissue,and thus create favorable conditions for good fracture healing and joint function recovery.