手术治疗Pilon骨折的临床疗效观察

Operative treatment and clinical results on Pilon fractures

目的初步探讨手术治疗Pilon骨折临床疗效的相关因素。方法选取Pilon骨折43例（43侧）行延期切开复位钢板、螺钉内固定并自体髂骨植骨术。从Tornetta等踝关节功能评分和Burwell—Charnley影像学两方面进行疗效评价。结果随访43例，总体优良率76．7％，解剖复位组与非解剖复位组的临床优良率分别为85．2％和43．8％（P〈0．01），Ⅱ型骨折组和Ⅲ型骨折组的临床优良率分别为89．3％和53．3％（P〈0．05）。结论手术治疗移位Pilon骨折可获得满意的疗效，其中骨折的复位质量、骨折类型与疗效之间有重要关系。

Objective To discuss the relative factors of the clinical results of operative treatment on Pilon fractures. Methods Summarized the experience in treatment of 43 cases of Pilon fractures. Forty - three cases were treated with open reduction and internal fixation with plates and screws, and received auto - ilium transplant. The final outcomes of treatment were evaluated based on the Tornetta and Burwell - Charnley radiographic grade. Results Forty - three cases were followed up, of which the total excellent and good rate was 76.7% , anatomic and non - anatomic reduction group were 85.2% and 43.8% respectively （ P 〈0.01 ） , type Ⅱ fracture and type Ⅲ fracture group were 89.3% and 53.3% respectively （ P 〈 0.05 ）. Conclusions Operative treatment can provide satisfactory outcome for Pilon fractures, of which it is important implication on the type of the fracture and reduction quality and clinical results.