早-中-晚三期辨治Pilon骨折微创(有限内+超踝外固定)术后90例临床观察

Treatment of Pilon Fracture with Limited Internal Fixation combined with External Fixation and Installment Syndrome Differentiation 90 Cases of Clinical Observation

[目的]观察早-中-晚三期辨治Pilon骨折微创（有限内＋超踝外固定）术后疗效。[方法]使用前瞻性设计方法,对90例住院患者微创手术（有限内固定＋超踝外固定）,术后三期辨证施治,早期（术后1-2周）活血化瘀止痛丸（三七、红花、乳香各10g,没药6g,白芷3g,续断8g,马钱子3g,土鳖虫6g,自然铜5g）10g/次,3次/d,早中晚温水送服;中期（术后2-4周）接骨续筋丸（威灵仙、天南星各10g,没药6g,地龙10g,炙甘草、土鳖虫各6g）10g/次,3次/d,早中晚温水送服;晚期（术后〉4周）补肾壮骨丸（五味子8g,肉豆蔻、枸杞子、淮山药各10g,牡丹皮6g,泽泻8g,熟地10g,茯苓、菟丝子各8g）10g/次,3次/d,早中晚温水送服。连续治疗2周为1疗程。观测临床症状、不良反应。连续治疗4疗程,判定疗效。[结果]优64例,良10例,可6例,差10例,优良率88.89%。[结论]早-中-晚三期辨治Pilon骨折微创（有限内＋超踝外固定）术后,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the limited internal fixation＋super external fixation of ankle joint staging treating Pilon fracture curative effect. ]Methods] Using the prospective design method of minimally invasive surgery treatment for 90 cases of hospitalized patients postoperative 3 period, making early promoting blood circulation to remove blood stasis pain pill （notoginseng, each 10 g safflower, frankincense, myrrh, 6 g angelica dahurica 3g, radix dipsaci 8g, nux vomica 3g, 6g ground beetle, natural copper 5g） 10 g/time, 3 times/d, early take one warm water; Medium-term bone renew reinforcement pill （clematis root, rhizoma arisaematis each 10g, 6g myrrh, 10g earthworm, main licorice, eupolyphaga each 6g） 10 g/time, 3 times/d, early take one warm water; Advanced kidney strong bone pill （fructus schisandrae 8g, nutmeg, medlar, yam medicine every 10g, cortex moutan 6g, alisma 8g, prepared rhizome of rehmannia, 10g, tuckahoe, dodder 8g） 10g/time, 3 times/d, early one with warm water. For 2 weeks to 1 treatment course of treatment. Observation of clinical symptoms and adverse reactions. 4 courses of continuous treatment, judge curative effect. ]Results] Excellent in 64 cases, good in 10 cases, fair in 6 cases and poor in 10 cases, was 88.89%.[Conclusion] Super external fixation of ankle joint staging treating Pilon fractures, curative effect is satisfied, no serious adverse reactions, worthy of promotion.