摘要
目的:探讨采用改良后内侧入路支撑钢板固定治疗后Pilon骨折的临床疗效。方法:自2014年7月至2015年1月手术治疗10例后Pilon骨折患者,其中男3例,女7例,年龄31~54岁。根据俞光荣等提出的后Pilon骨折分型,Ⅰ型1例,Ⅱ型3例,Ⅲ型6例。所有患者采用改良后内侧入路支撑钢板内固定治疗。记录患者术后并发症、骨愈合及复位情况,并予术后1年采用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足功能评分评价临床疗效。结果:10例患者均获随访,时间12~18(14.1±3.2)个月。患者术后切口均Ⅰ期愈合,无切口感染、血管神经损伤及屈肌腱挛缩发生。术后根据Burwell-Charnley影像学评价标准判定骨折复位,后踝解剖复位8例,复位良好2例。所有骨折均获得愈合,时间12~16(13.2±1.8)周。术后1年根据AOFAS评分评定临床疗效,优8例,良2例。患者术后3~6(4.7±1.4)个月重返原工作岗位。结论 :改良后内侧入路支撑钢板固定治疗后Pilon骨折临床疗效肯定,并发症少,患者可以早期负重功能锻炼。
Objective:To explore clinical outcomes of buttress plating in treating posterior Pilon fracture by amodified posteromedial approach. Methods:From July 2014 to January 2015,10 patients with posterior Pilon fracture were respectively analyzed,including 7 females and 3 males,aged from 31 to 54 years old. One patient were typeⅠ,3 patients were typeⅡand 6 patients were type Ⅲ according to classification of Pilon fracture by YU Guang rong. All patients were treated by buttress plating through amodified posteromedial approach. Postoperative complications,fracture healing and reduction were observed,AOFAS score were used to evaluate function recovery at 1 year after operation. Results:All patients were followed up for 12 to 18 months with an average of(14.1±3.2) months. All incisions were primarily healed at stageⅠwithout wound complication,neurovascular injuries or musculus flexor contracture. According to Burwell-Charnley imaging scoring,8 patients got anatomical reduction and 2 patients got moderate reduction. All fracture got healing from 12 to 16 weeks with an average of(13.2±1.8)weeks. According to AOFAS score at 1 year after operation,8 got excellent results and 2 moderate. All patients returned to work at about(4.7±1.4) months(ranged from 3 to 6 months) after operation. Conclusion:Buttress plating using a modified posteromedial approach in treating posterior Pilon fractures is an effective method,has less complications,and could recovery early weight bearing functional exercise.
作者
解冰
田竞
周大鹏
薛海鹏
杨超
张昊
田帅
王源伟
胡汉
XIE Bing;TIAN Jing;ZHOU Da-peng;XUE Hai-peng;YANG Chao;ZHANG Hao;TIAN Shuai;WANG Yuan-wei;HU Han(Department of Orthopaedics,Shenyang Military Region GeneraI Hospital,Shenyang 110016,Liaoning,China)
出处
《中国骨伤》
CAS
2018年第7期656-660,共5页
China Journal of Orthopaedics and Traumatology
基金
2014年全军后勤重大项目(编号:AWS14C003)~~
关键词
胫骨骨折
骨折内固定术
内
外科手术
Tibial fractures
Fracture fixation,internal
Surgical procedure,operative