Pilon骨折的治疗

TREATMENT OF THE PILON FRACTURE

作者自1988年1月至1993年12月收治Pilon骨折31例，根据Riled的分类祛：Ⅰ型5例，Ⅱ型10例，Ⅲ型16例．手术治疗22例，保守治疗9例．随访l－4年，疗效按Bourne的标准评定，Ⅰ型骨折手术或保守治疗优良率100％，Ⅱ、Ⅲ型骨折手术治疗优良率85％，保守治疗优良率33．3％．作者认为Pilon骨折Ⅱ、Ⅲ型应手术治疗．保守治疗仅用于Ⅰ型骨折．手术控AO的四步重建法进行．但严重的粉碎骨折或开放骨折伴软组织缺损，内固定确定难干实施者，则改用踝部超关节外固定支架固定．

We treated 31 cases of Pilon fracture from Jan 1988 to Dec1993. According to Riiedi's classification, there were 5 cases of type Ⅰ, 10 of type Ⅱ and 16 of type Ⅲ. 22cases of them were treated by surgical treatment and the rest by non - surgical treatment. All patients were followed up for Ⅰ -4 years and the reault was assessedwith Bourn's method. All of type Ⅰ were ex cellent whether they were treated by surgical or non-surgica Ⅰ therapy. The patients of type Ⅱ and type Ⅲ gained 85% of excellent by surgical therapy and 33. 3% of goodby non-surgical therapy. The results indicate that the type Ⅱ and Ⅲ of Pilon fracture must be operated, non-surgical treatment could only be applied to type Ⅰ. Operative method was carried out by means of the 'four reconstructed steps '. recommended by Ao. A serious comminuted fracture or open fracture with deficit of soft tissues should firstly be used external fixing support over ankle joint.