治疗复杂Pilon骨折的临床研究

Clinical research of the treatment for Pilon fractures of complex

目的:探讨复杂Pilon骨折的手术时机,有限内固定结合外固定的治疗效果。方法:回顾性分析和总结本院2001年3月～2009年3月收治的57例复杂Pilon骨折患者的临床资料,进行急诊手术,消肿,抗感染,跟骨牵引,延期手术有限内固定结合外固定等一系列手术措施。结果:本组病例获5个月～5年随访,平均15个月,术后1年骨折均正常愈合,严重创伤性关节炎2例(随后行踝关节融合),局部皮肤感染坏死1例(为开放性骨折,后行二期皮瓣转移创面修复),总体效果优37例,良9例,中9例,差2例。结论:正确判断骨折和软组织创伤情况。掌握好手术时机及综合使用各手术方式保护好局部血运是治疗复杂Pilon骨折的关键。

Objective：To investigate the optimal time for operation of Pilon complex fractures and the curative effect of limited internal fixation and external fixation treatment.Methods：Retrospective analyzed and summarized of our hospital from March 2001 to March 2009 Pilon fractures treated 57 cases of complex cases for emergency surgery,swelling,anti-inflammatory,calcaneal traction,delayed operation with limited internal fixation and external fixation.Results：The patients were followed up for five months to 5 years,an average of 15 months,after 6 months were normal fracture healing,arthritis two cases of severe traumatic ankle fusion line,then,necrosis in 1 case of local skin infection（as development of fractures,wounds underwent flap repair）,the overall excellent results in 37 cases,good in 9 cases,middle in 9 cases and poor in 2 cases.Conclusion：The right to determine fracture and soft tissue trauma situations,master the optimal time of operation and the integrated use of various surgical procedures to protect the local blood supply is the key to the treatment of complex fractures of the Pilon.