25例开放性Ⅲ型Pilon骨折手术疗效分析

Clinical Analysis of the Result of Surgery of 25 Cases with Type Ⅲ Open Pilon Fractures

【目的】探讨治疗开放性Ⅲ型Pilon骨折的有效方法及临床疗效。【方法】回顾分析2003年9月至2008年9月收治的25例Ⅲ型Pilon骨折的手术治疗情况。患者平均年龄38（18～59）岁，其中15例严重开放性骨折行超踝关节外固定支架固定，10例软组织损伤较轻开放性骨折行有限开放复位内固定＋组合外固定支架固定。术后随访6～30个月。【结果】根据Mazur评定标准，优7例，良12例，可4例，差2例。优良率为76％。【结论】加强周围软组织的保护、制定合适的治疗方案是治疗开放性Ⅲ型Pilon骨折成功的关键。

[Objeetive]To explore the effective method and clinical efficacy of the operation for type Ⅲ Pilon open fractures. [Methods] Twenty five patients with type ⅢPilon fracture operated in our department from September 2003 to September 2008 were analyzed retrospectively. The average age of patients was 38 years old（ranging from 18 to 59 years old）. Among all patients, 15 cases of severe open fractures were treated with bestrided ankle external fix- ation and 10 cases of minor open fractures were treated with combined external fixation and limited internal fixation. All cases were followed up from 6 months to 30 months. [Results]According to Mazur,s criteria,the result was evaluated as excellent in 7 cases,good in 12 cases,fair in 4 cases and pool in 2 cases. The excellent and good rate was 76 %. [Conclusion]It is critical for a successful operation of type Ⅲ Pilon open fractures to protect surrounding soft tissue carefully and to establish right procedure of surgery.