Pilon骨折分步延期切开复位内固定的疗效分析

Clinical Evaluation of Step -by- step Delayed Open Reduction and Internal Fixation for Pilon Fracture

目的：探讨分步延期切开复位内固定治疗Pilon骨折的临床疗效。方法：对23例闭合性pilon骨折的患者全部采用分步延期切开复位内固定治疗,术后行石膏托外固定及定期X片复查。结果：本组患者均获随访,术后随访18～48个月,平均32.6个月。所有骨折均获骨性愈合,骨愈合时间2～15个月,平均4.8个月。采用Tenny踝关节功能评分系统：优12例,良6例,可4例,差1例。优良率为78.3%。术后并发症包括皮肤坏死1例;无骨髓炎及窦道的发生;3例患者出现踝关节退行性变。结论：根据骨折类型,把握手术时机,同时采用适当的固定方式,及术后正确康复训练,是取得优良疗效的关键。

Objective： To investigate the clinical efficacy of step - by - step delayed open reduction and internal fixation on Pilon fractures. Methods： 23 cases of closed pilon fractures in patients with step - by - step delay open reduction and internal fixation, plaster external fixation and the periodic review of X - ray. Results： The patients were followed up after 18 -48 months, an average of 32.6 months. All fractures were bone union, bone healing time of 2 -15 months, an average of 4.8 months. Tenny ankle function scoring system： excellent in 12 cases, good in six cases, four cases fair, and poor in 1 case,with an excellence rate of 78.3%. Post-operative complications included 1 case of skin necrosis; with-out the occurrence of osteomyelitis and sinus; three cases of patients with degenerative ankle. Conclusions： based on the type of fracture, grasp surgical opportunity, at the same time the use of appropriate fixation methods, and postoperative rehabilitation correctly are the key to a good effect.