Pilon骨折65例

Pilon Fracture in 65 Cases

目的讨论Pilon骨折的治疗方法的选择及减少并发症的有效办法。方法对65例Pilon骨折分别进行治疗，单纯石膏外固定6～8周者12例，跟骨结节牵引6～8周者11例，行骨折早期切开复位为固定36例，行踝关节融合术6例。行手术者中采用局部网状小切口减压引流12例。结果随访平均5．3年，骨折延迟愈合8例，不愈合3例，并发浅表感染8例，并发深部感染4例。依据Bourne标准，优良：41例，可：13例，差：5例。结论Pilon骨折应依据病情采用不同的治疗方法，骨折均需解剖复位，有手术指征者应尽可能在12小时内进行，网状小切口减压引流能有效地防治伤口感染。

Aim To discuss the selection of therapeutic methodly for Pilon fracture and foe effective way for decreasing complication. Methods 65 patients with Pilon fracture were treated with different methods respectively, 12cases with immobilization in a cast for 6-8 weeks, 11 cases with calcancal traction for 6-8 weeks, 36 cases with early opening reduction and internal fixation, and 6 cases with ankle arthrodesis. In 12 out of the operated cases, local meshed decompression by short incisions was adopted. Results The Patients were followed up for o. 3 years in average.Delayed union was found in & cases, nonunion in 3 cases, superficial wound infection in 8 cases, and deep infection in 4 cases. According to Bourne's criteria, the therapeutic effects.were excellent and good in 41 cases, fair in 13 cases and poor in 5 cases. Conclusion The patients with Pilon fracture must be treated in different way according to the classificanon of the fracture. The anatomical reduction of fracture musl be achieved. The operation must be performed within 12 hours. The meshed decompression with short incisions is an effective method for preventing wound infection.