延期切开复位内固定治疗C3型Pilon骨折

Treatment of Open Reduction and Internal Fixation and Bone Grafting After Improvement of Soft Tissue Conditions of AO Classification Type C3 Pilon Fracture

目的探讨采用延期切开复位内固定治疗C3型Pilon骨折的临床效果。方法对23例C3型Pilon骨折采用延期切开复位内固定并植骨治疗,术后延期非负重状态下早期踝关节活动。结果所有病例随访8～56个月,骨折均愈合,愈合时间11～30周,平均13.8周,无内固定松动及断裂现象。根据AOFAS踝与后足评分标准:优9例,良11例,可2例,差1例;优良率87%。结论采用延期切开复位内固定并植骨治疗C3型Pilon骨折,能显著减少并发症并提高踝关节功能。

Objective To investigate the clinical efficacy of open reduction and internal fixation and bone grafting after improvement of soft tissue conditions in treatment of AO classification type C3 Pilon fracture.Methods Twenty-three cases of Pilon fractures were enrolled.All patients were treated by open reduction and limited internal fixation and bone grafting after improvement.Results All the patients were followed up from 8 to 56 moths.The time of fracture healing ranged from 11 to 30 weeks,averaged 13.8 weeks.According to American Foot and Ankle Society（AOFAS） ankle and hind foot function score,the functional results of ankle included 9 excellent（90～100 points）,11 good（75～89 points）,2 fair（50～74 points）,1 bad（〈50 points）.Conclusion The open reduction and limited internal fixation and bone grafting after improvement of soft tissue condition can achieve good clinnical efficacy in treatment of C3 Pilon fractures.