小切口锁定重建钢板单皮质固定治疗Pilon骨折

Application of single-cortex fixation with locking reconstruction plate through minimal-incision approach in treatment of Pilon fractures

目的：探讨采用小切口及锁定重建钢板单皮质固定技术治疗 Pilon骨折的临床效果。方法：对23例复杂的Pilon骨折采用小切口复位，并放置锁定重建钢板行单皮质固定支撑。术后定期随访复查，并对踝关节功能进行评分。结果：23例患者在术后得到10～16个月时间不等的随访期，23例患者骨折愈合顺利，未发生钢板螺钉断裂。根据Mazur评分标准，踝关节功能恢复满意：其中优15例，良6例，可2例。无伤口感染、骨不连，关节僵直及力线不良等并发症。结论：根据pilon骨折具体情况，在骨折移位显著处作小切口，微创操作复位骨折，再放置锁定重建钢板，骨折线远近侧单皮质螺钉固定。可达到少剥离，保护软组织及骨膜血供，在多平面予以骨折有效支撑，疗效满意。

Objective：To study the clinical outcomes of single -cortex fixation with locking reconstruction plate through minimal -in-cision approach in the treatment of Pilon fractures .Methods：fractures were reduced through minimal incisions , and locking restruction plates were fixed by single -contex screws .23 cases with complex Pilon fracture were treated .All patients were followed up and the ankle function were scored and evaluated .Results：The follow-up period ranged from 10 to 16 months, all patients gained healing , with no broken plate and screws .According to Mazur score standard , 15 patients were graded good , 6 patients were graded moderate , 2 patients were graded acceptable.There were no complications such as infection, non-union, joint-stiffness and mal-alignment et al.Conclu-sion：Minimal incision were made in the area where fracture displaced most obviously , after reduction , locking restruction plates were used to fix the fractures by single -contex screws .This method might be effective to avoid soft tissue peeling and protect blood supply , the fratures were braced in multiple planes , thus gained satisfactory effects .