三叶板内固定术在Pilon骨折治疗中的临床应用

Clinical Application of Open Reduction and Internal Fixation with Cloverleaf Plate in the Treatment of Pilon Fractures

目的:探讨AO纯钛苜蓿形板(以下简称三叶板)内固定术治疗Pilon骨折的疗效。方法:采用切开复位三叶板内固定术治疗C型Pilon骨折21例。结果:随访12～36个月,平均随访18个月,21例骨折均愈合,临床愈合时间平均10周。1例伤口拆线后,钛板部分外露,换药直至骨愈合,取出所有内植物后,二期缝合,伤口愈合。本组无内植物折断、螺钉松动及骨不连等并发症。根据Pilon骨折的关节功能评分标准,本组疗效优10例,良8例,可3例,优良率为89%。结论:三叶板为主的切开复位内固定术治疗C型Pilon骨折,能达到坚强的固定,板材超薄,组织反应小,软组织和骨膜剥离少,对骨折局部血供破坏小,并发症发生率低,可早期进行踝关节功能锻炼,获得较满意的疗效。

Objective：To explore effects of internal fixation with cloverleaf plate for treating Pilon fractures. Methods：21 patients with type C Pilon fractures underwent open reduction and internal fixation with cloverleaf plate from January 2001 to January 2005. Results：The follow-up period was from12 to 36 months; the average time was 18 months. All fractures were good healing, their clinical unions present at mean of 10 weeks. Among them, one cloverleaf plate was exposed when taken out stitches in one patient, who underwent dressing change regularly until bone healing, whose implant was removed 36 weeks after operation, and incision was healed by secondary suture. There were no complications such as implant breakage, screw loosening,nonunion, etc. According to ankle joint function score, excellent in 10, good in 8, fair in 3, the excellent-good rates was 89%. ConclusionsOpen reduction and internal fixation with cloverleaf plate in the treatment of type C pilon fractures have advantages of rigid fixation, uhrathin plate, minor tissue reaction, little soft-tissue injures, few complications, permitting early functional training of gambrel, and could acquire satisfactory results