切开复位解剖钢板内固定治疗Pilon骨折32例

Open reducation anatomy plate internal fixation treatment 32 cases of Pilon fracture

目的探讨胫骨Pilon骨折的手术方法、手术时机及其效果。方法2004年9月至2007年4月本院收治Pilon骨折32例,其中Ruedi-AllgowerⅡ型18例、Ⅲ型14例。均采用切开复位、植骨、螺钉及解剖型钢板内固定。手术治疗时间为伤后2h^15d,平均7d。结果术后随访8~32个月,平均19个月。按Mazur评分标准:优12例,良14例,可4例,差2例,优良率81%。结论术前对损伤做出正确的评估,选择恰当的手术时机,钢板内固定能提供坚强内固定以利早期关节活动,术后有步骤进行主动加被动踝关节功能锻炼,使踝关节功能得到最大限度的恢复。

Objective To summarize the clinical data of the treatment Pilon fractures,and investigate the treatment of Pilon tractures to guide the clinical work. Methods From Sep. 2004 to Apr. 2007,Total of 32 cases with Pilon fractures type Ⅱ and Ⅲ were treated in our hospital. According to Ruedi-Allgower classification of Pilon fracture,there were 18 of type Ⅱ and 14 of type Ⅲ, all fractures were adopted open reducation and internal fixation. Results Thirty-two cases were followed up 8-32 months,average 19 months＇. Evaluated by Mazur＇s standard ：12 were excellent, 14 were good,the excellent and good rate was 81%. Conclusion Pilon fracture is a intra-aricular fracyure. We recommend：early correct diagnosis and treatment including the fracture was fixed by plate and processing initiative ＋passivity ankle function exercise to increase the recovery of ankle function.