有限内固定结合外固定治疗复杂Pilon骨折(Type Ⅲ)

Treament of Complex Pilon Fractures( Type Ⅲ) by Limited Internal Fixation Combined with External Fixation

目的探讨应用有限内固定结合外固定架治疗Rüedi-AllgowerⅢ型Pilon骨折的疗效。方法回顾性分析2007年9月至2014年5月应用有限内固定结合外固定支架治疗Rüedi-AllgowerⅢ型pilon骨折36例,观察术后并发症,进行术后Burwell-Charnley系统评价和踝关节功能评价。结果 36例患者均完全骨性愈合,随访6-15个月（平均10.5个月）,骨折临床愈合时间14-24周。出现并发症6例,并发症发生率为16.7%。按影像学标准Burwell-Charnley系统评价：优18例,良15例,优良率达91.7%;按术后踝关节功能评价：优14例,良16例,优良率达83.3%。结论有限内固定结合外固定是治疗Ⅲ型Pilon骨折的有效方法之一。

Objective To summarize the treatment effect of Rüedi-Allgower Type Ⅲ Pilon fractures by limited internal fixation combined with external fixation. Methods From September 2007 to May 2014,36 patients with Rüedi-Allgower Type Ⅲ Pilon fractures were treated with limited internal fixation combined with external fixation. The complication and clinical effect were analyzed according to Burwell-Charnley criterion,and function evaluation of ankle joint was evaluated. Results All cases were followed up from 6 to 15months（ 10. 5 months on average）,and they were all achieved bony union. The clinic healing time of fracture was between 14 to 24 weeks. Postoperative complications occurred in 6 patients（ 16. 7%）.According to Burwell-Charnley criterion for radiographic effect,18 cases were excellent,and 15 cases were good. The excellent and good rates were 91. 7%. According to the function of ankle joint for clinical effect.the excellent and good rates were 83. 3%. Conclusion Limited internal fixation combined with external fixation was an effective therapeutic method for Rüedi-Allgower Type Ⅲ Pilon Fractures.