Comparison of Effect of Two Kinds of Surgical Approaches for Treatment of Closed Sagittal Pilon Fracture

Objective To compare the effect of two kinds of surgical approaches for the treatment of topliss closed sagittal pilon fractures.Methods 60 patients with topliss closed sagittal pilon fractures who were treated with open reduction and internal fixation with buttress plates between Februry 2010 and Februry 2013 were selected and divided randomly into group A(n.=30) and group B(n=30).Patients in group A were treated by the anterolateral approach,while those in group B were treated by the posteromedial approach.Operation time,bleeding volume during operation,hospitalization time,the incidence of postoperative complications,Mazur ankle function score,fracture healing and reduction degree were considered as the evaluation standard.Clinical treatment effects of the two groups were observed and recorded.Results The analysis showed that the A group of patients with operation time(190.1±20.31) min,the amount of hemorrhage(220.46±28.98) ml,B group of patients with operation time(198.3±24.56) min,the amount of hemorrhage(230.52±34.68) mL,difference between the two groups was not significant,but the patients in the A group the time of hospitalization(20.34± 3.45) d and the incidence of postoperative complications of 10.1%is obviously superior to group B in hospitalized patients hospitalization time(28.56 ± 5.21) d and the complication rate was 4.35%,with statistical significance of P0.05,no significant difference between Mazur ankle function in patients of group A and group B scores of patients and the reduction degree of fracture healingand other aspects,P0.05 no statistical significance.Conclusion The study shows that the anterolateral approach for treatment can not only shorten the hospitalization time of patients,but also reduce the incidence of complications,and has important guiding significance in clinical application.