急诊切开复位有限内固定结合外固定架治疗Pilon骨折

Study on treatment of Pilon fracture with emergent open reduction and limited internal fixation combined with external fixator

目的探讨急诊切开复位有限内固定结合外固定架治疗Pilon骨折的临床疗效。方法采用急诊切开复位有限内固定结合外固定架治疗Pilon骨折21例。根据Ruedi-Allgower骨折分型:Ⅱ型11例、Ⅲ型10例。伤后距手术时间6～18 h(平均12 h)。按Teeny踝关节功能评分标准进行疗效评价。结果全部病例获得随访,随访时间6～26个月,平均18个月。骨折愈合时间12～24周(平均14.3周)。3例发生针道感染。踝关节功能评分:优8例,良9例,可3例,差1例。优良率为80.9%。结论采用急诊切开复位有限内固定结合外固定架治疗Pilon骨折,能减少并发症并获得较好疗效。

Objective To discuss the clinical outcome of Pilon fracture treated with emergent open reduction and limited internal fixation combined with external fixator. Methods Twenty one patients with Pilon fracture were treated with emergent open reduction and limited internal fixation combined with external fixator. According to Ruedi - Allgower classification, there were ll patients belonged to type Ⅱ and 10 patients to type Ⅲ. Operation was performed in 6 to 18 hours after injury with an average of 12 hours. The clinical results were evaluated by Teeny Ankle Score. Results All patients were followed up for 6 to 26 months （ 18 months on average）. The average healing period was 14.3 weeks （ 12 to 24 weeks）. Three patients had needle hole infection. There were 8 excellent, 9 good, 3 fair and 1 poor in results, according to Teeny Ankle Score. Conclusion The treatment of Pilon fracture with emergent open reduction and limited internal fixation combined with external fixator can reduce operative complications and gain satisfactory results.