胫骨远端Pillon骨折术式设计及临床效果分析

Distal Tibia Fractures Pillon Surgical Design and Clinical Effect Analysis

目的探讨胫骨远端Pillon骨折手术治疗的最佳方法和最佳治疗时机。方法回顾性分析2003年9月至2011年9月期间我院收治的39例胫骨远端Pillon骨折患者的临床资料。根据Ruedi-Allgower分型:Ⅱ型21例,Ⅲ型18例;开放性骨折10例,闭合性骨折29例;合并伤:腓骨骨折22例、脊柱骨折3例、距骨骨折1例、跟骨骨折2例、髋关节及骨盆骨折2例、其他部位骨折1例。39例胫骨远端Pillon骨折患者均行手术治疗。结果根据Mazur等制定评分系统进行评定:优20例、良10例、可6例、差3例。总优良率76.9%。术后2例患者并发轻度脂肪液化,1例发生严重创伤性关节炎。结论临床中胫骨远端Pillon骨折治疗的关键是手术前要制定详细周密的计划,手术时机要把握准确得当。只有根据不同的骨折情况,运用不同的手术方式,区别对待,因人而异,才能取得良好的手术效果,同时可以最大限度地减少并发症。

Objective Explore Pillon distal tibia fractures the surgical treatment of the best method and optimal timing of treatment Methods Retrospective analysis39 cases from September 2003 to September 2011 with Pillon distal tibia fractures .According to Ruedi-Allgower classification： type 17 21 cases, type 111 18 cases; Open fractures 10 cases, closed fracture 29; United injury： fibula 22 cases, spine fracture 3 cases, from the bone fracture, 1 case with bone fracture in 2 cases, hip and pelvic fractures in 2 cases, other parts of the fracture in 1 case. 39 cases distal tibia Pillon fracture patients were performed surgery treatment. Results According to Mazur et al assessed the development of scoring system： excellent in 20 cases, good in 10 cases, 6 cases and poor in 3 cases. Excellent and good rate of 76.9%. 2 patients were complicated by mild liquefaction of fat, 1 case of severe traumatic arthritis. Conclusion The clinical distal tibia Pillon fractures is key to formulate detailed before the operation careful plan, the operation time must grasp the accurate correctly. Only according to different fracture, and make use of different operation method, the difference treatment, because of the person different, can obtain good effect of surgery, and at the same time can minimize the complications.