胫骨下关节面骨折的临床治疗分析

Clinical research on the treatment effects on the patients with distal tibial articular surface fracture

目的分析总结胫骨下关节面骨折的治疗方法及治疗效果。方法对2006年1月至2010年2月我科收治的61例胫骨下段骨折波及胫骨下关节面患者的临床资料进行回顾性分析，其中Pilon骨折24例，跺部骨折37例，骨折根据受伤情况不同制定不同的治疗方案。结果Pilon骨折24例中，采用Tenny评分系统评估手术疗效，优17例，良5例，可1例，差1例。术后并发症包括皮肤感染3例，畸形愈合1例，踝关节融合术1例；踝部骨折37例，根据Baird—Jackson评分系统，优31例，良4例，可2例，差0例，术后并发症包括皮肤感染2例。结论了解Pilon骨折和踝部骨折不同的受伤机制和不同的治疗方法，能更好的治疗胫骨下关节面骨折。

Objective To research the operative methods and their clinical effects on distal tibial articular surface fracture. Methods From Jan. 2006 to Feb. 2010, 61 cases of tibial distal fracture with distal tibial articular surface fracture were retrospectively analysed in our department, in which Pilon fractures 24 cases, ankle fracture 37 cases. According to the different injurie situation adopted different treatment. Results In all pilon fractures patients, we assessed surgical treatment by Tenny grading system. Seventeen cases were perfect, 5 cases were good, 1 case was not too bad and 1 cases was very bad. Complications included 3 cases of skin infection, 1 case of malunion, 1 case of ankle arthrodesis after operation. In all ankle fractures patients, we assessed surgical treatment by Baird - Jackson grading system. Thirty -one cases were perfect, 4 cases were good, 2 cases were not too bad and 1 cases was very bad. Complications included 2 cases of skin infection after operation. Conclusions Understanding the difference of injurie mechanisms between Pilon fractures and ankle fractures, including different treatment between them, we can treat those patients with distal tibial articular surface fracture better.