腓骨内固定加管型石膏外固定治疗复杂Pilon骨折

Internal Fixation in Fibula plus Tubular Gypsum External Fixation for Pilon Fracture

目的探讨腓骨内固定加外固定治疗Pilon骨折的疗效。方法采用钢板螺钉内固定治疗腓骨骨折,然后用松质骨拉力螺钉或可吸收螺钉固定下胫腓关节,对压缩的胫骨取髂骨植骨,修复骨缺损,不做胫骨内固定手术,术后小腿管型石膏外固定。结果46例Pilon骨折,优36例,良5例,中3例,差2例。其中2例感染,皮肤伤口半年愈合,总优良率89.1%。结论有限内固定结合术后管型石膏外固定治疗Pilon骨折具有损伤小、愈合快、并发症少的优点。

Objective To explore the treatment method and efficacy of Pilon fracture. Methods Internally fixated the fibular fracture with plates and screws ,and then fixed the distal tibiofibular joint with compressing screws or absorbable screws. To those with tibial compression fractures,treated bone defect with iliac graft,rather than internal fixation. Tubular gypsum external fixation was used after the surgery. Results At follow-ups ,of the 46 patients with Pilon fractures,the results were evaluated excellent in 36,good in five,fare in three,and poor in two. Two patients were complicated with post-operation infection,and the skin wounds were healed in 6 months. The total superior and good rates were 89. 1%. Conclusion Limited internal fixation plus post-operation tubular gypsum external fixation for Pilon fracture is characterized by small wound,quick healing and fewer complications.