应用四柱理论和微创经皮锁定钢板治疗Pilon骨折的疗效分析

Efficacy of using four-column theory and minimally invasive percutaneous plate osteosynthesis for treatment of Pilon fractures

目的探讨利用四柱理论结合微创经皮锁定钢板内固定技术（MIPPO）治疗Pilon骨折的临床疗效。方法自2010-12—2013-01对22例Pilon骨折采用四柱理论结合MIPPO技术治疗,根据四柱理论中不同柱骨折选择手术入路和固定方式。结果 19例切口一期愈合,3例出现切口皮缘少许坏死,经换药后愈合。22例获得平均15（12~22）个月随访,无内固定松动、断裂。骨折复位情况应用Burwell-Charnley影像学评估标准评定：解剖复位15例,复位一般7例。均在术后16~18周获得骨性愈合,末次随访时按AOFAS评分评定临床疗效：优10例,良7例,可3例,差2例（均为Ruedi-AllgowerⅢ型骨折）。结论采用四柱理论结合MIPPO技术治疗Pilon骨折是一种有效地手术方式,临床效果满意。

Objective To explore the clinical efficacy of using the four-column theory and minimally invasive percutaneous plate osteosynthesis （MIPPO） for Plion fractures. Methods From December 2010 to January 2013 22 patients with Pilon fracture were included, they were treated with of the four-column theory and MIPPO. According to the four-column theory different column fractures were treated alternatively the surgical approach and different methods of internal fixation. Results Twenty two cases of surgical patients were followed up for 12-22 months, an average of 15 months. Radiographic fracture case assessment was used by Burwell-Charnley Standard： anatomically 15 cases, seven cases generally. Reset by the AOFAS scores were excellent in 10 cases, good in 7 cases, fair in 3 cases, and poor in 2 cases. Conclusion For Pilon fracture, the fourcolumn theory and MIPPO is an effective surgical procedure. The clinical effect was satisfactory.