有限内固定结合外固定支具治疗高能量胫骨Pilon骨折

Limited internal fixation combined with external brace for high energy Pilon fracture

目的总结有限内固定结合外固定支具治疗高能量Pilon骨折的治疗效果。方法我院2004年3月至2009年1月治疗高能量胫骨Pilon骨折39例。年龄25～69岁,平均40.3岁。其中合并腓骨骨折25例,开放性骨折21例。39例均以克氏针和螺钉有限内固定胫骨骨折端,术后外支具固定2～3个月。结果所有病例均获随访,无一例出现伤口感染、皮肤坏死和内固定物外露,所有骨折均愈合良好。根据Mazur踝关节评分标准,本组39例,优13例,良18例,可6例,差2例。结论有限内固定结合外固定支具治疗高能量Pilon骨折可取得良好的治疗效果,是治疗高能量Pilon骨折较满意的方法。

Objective To evaluate the outcome of limited internal fixation combined with external brace for high energy Pilon fracture.Methods Thirty-nine cases of high energy Pilon fracture were treated in our department from March 2004 to January 2009.The average age was 40.3 years（range from 25 to 69）.21 cases were open fracture,25 cases were accompanied with fibular fracture.All cases were treated with limited internal fixation with screws or Kirschner wires,postoperatively external brace for from 2 to 3 months.Results All patients were followed up.No case was found the infection of wound,the necrosis of skin or the exposure of internal fixation,the fractures of all cases unioned well.According to Mazur’s criteria,the result was evaluated as exellent in 13 cases,good in 18 cases,fair in 6 cases,poor in 2 cases.Conclusion Limited internal fixation combined with external brace is a satisfatctory method of treatment for high energy Pilon fracture.