三叶草钢板治疗Pilon骨折的并发症原因分析及防治

Analysis of causes and prevention of complications of the tibial Fourty-two Pilon fractures treated with Ⅲ leaves type plate

[目的]观察三叶草钢板治疗Pilon骨折的并发症的原因及防治措施。[方法]1999年7月～2003年12月用三叶草钢板治疗Pilon骨折42例。男30例，女12例；年龄15～62岁，平均45．3岁；开放性骨折9例，闭合性骨折33例；参照Ruedi＋Allgower骨折分型方法，Ⅰ型15例、Ⅱ型18例、Ⅲ型9例。[结果]42例均得到随访，平均28个月（14～60个月）；骨折愈合11～26周，平均16周。术后并发症主要有伤口浅表感染6例，深部感染2例，踝关节严重创伤性关节炎2例，踝关节强直1例。踝关节功能根据Bourne标准，优19例，良17例，可4例，差2例，优良率为85．7％。[结论]三叶草钢板治疗Pilon骨折疗效显著，但是存在一定的并发症，在临床使用中必须引起高度重视。

[ Objective] To observe complications of tibial pilon fractures with Ⅲ leaves type plate and analysis of causes and prevention of complications. [ Method] Fourty-two cases of the final pilon fractures were treated with Ⅲ leaves type plate from July 1999 to December 2003. There were 30 males and 12 females, the average age was 45.3 years （ranged,15 -62 years） ,9 cases were open fracture and 33 cases were open fracture. According to the Ruedi-Allgower classification, there were 15 cases of type Ⅰ fracture, 18 cases of type Ⅱ fracture and 9 cases of type Ⅲ fracture. [ Result] Fourty-two cases were followed up for an average of 28 months （ranged, 14 -60 months ）, The time to fracture union averaged 16 weeks（ ranged, 11 -26 weeks ）. The complications included infection in 6 cases ,cases with severe traumatic arthritis and 3 cases with ankylosis. After evaluated according to the criteria of Bourne, there were 19 cases assessed as being excellent, 17 as good and 2 as poor, the excellent and good rate was 85.7%. [ Conclusion] Ⅲ leaves type plate is a good internal fixation for tibial pilon fractures, but the complications should be prevented.