有限内固定加外固定支架固定治疗C型胫腓骨骨折和Pilon骨折

Treatment of Type C Tibia and Fibula Fracture and Pilon Fracture with Limited Internal fixation and External Fixator

目的 探讨一种适合C型胫腓骨骨折和Pilon骨折的治疗方法。方法 自1996年6月～2005年6月对C型胫腓骨骨折36例和Pilon骨折12例，采用有限内固定加外固定支架固定治疗。结果 48例患者平均随访12（10～16）个月，无切口、伤口及钉道感染，无神经、血管损伤等并发症，临床疗效满意。36例C型胫腓骨骨折，按Johner—wruhs评分标准为优27例，良9例。12例Pilon骨折，按Ma—zur等踝关节症状和功能评分法，术后评分平均85（73～93）分，踝关节功能优2例，良8例，可2例；按Marsh踝关节关节面骨折复位评分法，优良者8例，中等4例。结论 有限内固定加外固定支架固定是治疗C型胫腓骨骨折和Pilon骨折的较好方法。

Objective To investigate the reasonable management for type C tibia and fibula fracture and Pilon fracture. Method From June 1996 to June 2005,36 cases of type C tibia and fibula fracture and 12 cases of Pilon fracture underwent limited internal fixation and external fixator. Results All the 48 cases were followed up for 10 to 16 months（ average 12 months）. No infection presented in wound or nail path. There was no iatrogenic injury of nerve and vessels. 36 cases of type C tibia and fibula fracture were evaluated according to Johner-wruhs marking standard, showing that excellent in 27 cases and good in 9 cases. 12 cases of Pilon fracture were scored 73 - 93 postoperatively （ average 85 ） according to Mazur ankle-joint symptom and function criteria and showed 2 cases excellent, 8 cases good and 4 cases fair regarding to ankle-joint fuction; according to Marsh ankle-joint articular facet fracture reduction criteria, it showed that 8 cases excellent and 4 cases good. Conclusion Limited internal fixation and external fixator are satisfactory method for type C tibia and fibula fracture and Pilon fracture.