胫骨Pilon骨折治疗方法及疗效分析

Discussion and analysis on the treatment and curative effect of shinbone Pilon fracture

【目的】探讨胫骨Pilon骨折的治疗方法及临床疗效。【方法】对27例胫骨Pilon骨折(Ruedi-allgower分型标准I:型9例,Ⅱ型14例,Ⅲ型4例)所采用的治疗方法及临床疗效进行评估和分析。对9例I型骨折中的4例行管型石膏固定,5例行闭合复位后直接经皮用拉力螺钉固定;对Ⅱ、Ⅲ型患者均行切开复位内固定术。【结果】按Mazur制定的踝关节功能评分标准:优15例,良7例,可4例,差1例。优良率81.5%。【结论】切开复位内固定是治疗胫骨Pilon骨折的有效方法,受损软组织的保护、手术时机的选择、术中骨折复位的质量及术后功能锻炼是决定临床疗效关键因素。

【Objective】 To discuss and analyze the methods of treatment and clinical curative effect of shinbone Pilon fracture.【Methods】 To evaluate and analyze the treatment and clinical curative effect on 27 patients with Ruedi-Allgower type I,II and III shinbone Pilon fracture（I=9,II=14,III=4）.Four cases were fixed with cast,the others in type I were fixed by hollow screw after closed reduction;Ruedi-Allgower type II and III were treated by open reduction and internal fixation.【Results】 The scoring system MAZUR assessment of the efficacy for treatment was used.There were 15 cases of excellent,good in 7 cases,relief in 4 cases and poor in 1 case,the rate of excellent and good was 81.5%.【Conclusion】 Open reduction and internal fixation is the effective treatment of the shinbone Pilon fracture.And the protection of impaired parenchyma,choice of appropriate time,quality of open reduction and internal fixation during the operating and favourable function exercise are the key agent for cxcellent clinical curative effect.