ObjectiveTo investigate the therapeutic effect of two surgical approaches on distal tibial comminuted fracture (Pilon fracture) and its effect on ankle joint function.

MethodsFifty patients with Pilon fracture of distal tibia were selected as the study subjects and divided into observation group and control group according to the surgical approach.The control group was treated with anterolateral approach of distal tibia, and the observation group was treated with anterolateral approach combined with posterolateral approach.The perioperative relevant indexes, postoperative imaging reduction, postoperative clinical therapeutic effect, postoperative functional recovery and adverse reactions were compared between the two groups.

ResultsThere was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05), but there was significant difference in fracture healing time between the two groups (P < 0.05).According to Burwell-Charnley evaluation criteria, the excellent and good rate of the control group was significantly lower than that of the observation group (P < 0.05).According to Tornetta standard analysis of treatment effect, the excellent and good rate of the observation group was significantly higher than that of the control group (P < 0.05).Kofoed and AOFAS scores in the observation group were significantly higher than those in the control group (P < 0.01).There was no significant difference in the occurrence of postoperative adverse reactions between the two groups (P>0.05).

ConclusionsCompared with the anterolateral approach of the distal tibia, the anterolateral approach combined with posterolateral approach for Pilon fracture can effectively improve the ankle joint function, shorten the postoperative recovery time of patients, and have better safety.