Abstract：Objective To evaluate the clinical effect of posterolateral combined anteromedial approach in the treatment of complex Pilon fractures. Methods A total of 48 patients with complex Pilon fracture admitted to Yancheng First People′s Hospital from April 2018 to May 2020 were selected retrospectively as the research objects. The patients were divided into posterolateral group (22 cases) and combined group (26 cases) according to different surgical approaches.The posterolateral group was treated with posterolateral approach and the combined group was treated with anterolateral and posterolateral approach. The related surgical indexes, postoperative pain degree, regression effect of swelling of affected limbs, incidence of complications were compared between the two groups. Results The average operation time and postoperative hospital stay of the combined group were longer than those of the posterolateral group, and the amount of bleeding and drainage of the combined group were more than those of the posterolateral group, and the fracture healing time of the combined group was shorter than that of posterolateral group, the differences were statistically significant (P＜0.05). The visual analogue scale (VAS) scores of the combined group were lower than those of the posterolateral group at 1, 2 and 3 weeks after operation, and the Mazur score of the combined group was higher than that of the posterolateral group after operation, the differences were statistically significant (P＜0.05). The regression effect of swelling of affected limbs of the combined group was higher than that of the posterolateral group, and the total incidence of postoperative complications of the combined group was lower than that of the posterolateral group, the differences were statistically significant (P＜0.05). Conclusion Posterolateral combined anteromedial approach is used in the surgical treatment of complex Pilon fractures, can effectively reduce the postoperative pain and swelling, improve the postoperative ankle symptoms and mobility of patients, and can effectively reduce postoperative complications, help to improve patients′ prognosis.
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