Analysis Of Factors That Impacts The Effectivenss Of The Surgical Treatment Of â…¡~â…¢ Type Pilon Fracture

ObjectiveBy reviewing the records of all patients who suffered Ruedi AllgowerⅡⅢPilon type fracture and received their medical treatment in Foshan Chinese Medicine Hospital during 2007-2009 and using the statistical analysis software SPSS17.0, I evaluate and analyze the relations between patients' age, timing for surgery, surgery techniques, fractures type, postoperative complications, Chinese medicine and the function score of ankle symtoms, so as to provide clinical evidence and reference in the purpose of improve the effectiveness of the future treatment of Ruedi AllgowerⅡ～ⅢPilon type fracture.MethodsThrough the electronic medical record system of Foshan Chinese Medicine Hospital, which is an affliliated hostital of Guangzhou Chinese Medicine University, I calculate that from January 2007 to December 2009, totally 300 patients were diagnosed to have the Ruedi AllgowerⅡ～Ⅲpilon type fractures. I review their records completely and take notes of their age, gender, X-ray number, surgery techniques, fracture type, postoperative complications and the use of Chinese medicine. I contact the patients to come back to hospical and score the mazur ankle function objectively by several people. The patients'information collected from the clinical work is put into the computer timely to build up a related database for better management. I use the Chinese version of SPSS17.0 statistical analysis software. The overall effectiveness of the treatment of the single factor analysis is illustrated by a percentage number. By taking the non-conditional logistic regression mode analysis, I check the the impact of the potential factors on the ankle functions scores of patients who received treatments to cure the theⅡ～Ⅲpilon type fractures. Firstly I analyse the single factors. If P<0.05 for the difference is of statistical meanings, then I go back and remove the factors. For the factors that hav statistical meanings, I carry out the multiple logistic regression analysis. If P<0.05 for the difference is of statistical meanings. From the above mentioned analysis, I analyze the the various risky factors that will have effect on mazur ankle score, which will provide the best clinical guidance.Results255 patients out of the total 300 patients take the visit and complete the whole procedures, with visit rate to be 85%. Among he Mazur ankle function scores,126 patients are scored excellent,88 are good, with the excellent goods rateto be 84%. Their fracture types are:179 cases belong to TypeⅡ, accounting for 70.2%; 76 cases belong toⅢ-type, accounting for 29.8%. Surgical techniques:in the stent group there are 173 cases, accounting for 67.45%; plate group 82 cases, accounting for 32.55%. With regard to the age group:from 19 years old to 28 years old, there are 69 cases with excellent good rate to be72.46%; from 29 years old to 38 years old, there are 66 cases with excellent good rate to be 80.3%; from 39 years old to 48 years old, there are 60 cases with excellent good rate to be 86.67%; from 49 years old to 63 years old there are 53 cases with excellent good rate to be 96.23%. By taking the ankle function score after theⅡ～Ⅲ-type pilon fractures surgery as the dependent variable, and taking the age, gender, fracture type, surgical techniques, timing for surgery, quality of reduction, complications and other factors as independent variables, I build up the logistic regression model analysis. Judging from the single factor logistic regression analysis (P <0.05), the quality of reduction, surgical techniques, timing of surgery, fracture type are the key factors that have great impact on the effectiveness of the clinical treatment of theⅡ～Ⅲtype pilon surgery, among which facture types has the highest OR value to be 41.299, followed by the postoperative quality of reduction with OR value to be 34.741. In conclusion, we know that the effectiveness of the clinical treatment of theⅡ～Ⅲtype pilon surgery have the most to do with the fracture type and the quality of reduction. The surgical techniques and timing for surgery following up have also an significant impact.Conclusion Timing of surgery, surgical approach, fracture type, quality of reduction is of typeⅡ～Ⅲpilon fractures of the ankle joint function after scoring, in addition, fracture type and quality of reduction is the most important.