锁定钢板治疗老年性胫骨Pilon骨折

The treatment with locking plate for tibia Pilon fractures of the elderly

目的探讨锁定钢板治疗老年胫骨Pilon骨折的方法和疗效。方法回顾性分析锁定钢板内固定治疗11例老年Pilon骨折的临床资料;根据MüllerAO分型:B2型2例,B3型1例,C1型3例,C2型2例,C3型3例;Ruedi-Allgower分型:Ⅰ型2例,Ⅱ型5例,Ⅲ型4例。11例在无明显手术禁忌情况下,均行开放复位锁定钢板内固定术。结果术后随访13~25个月,平均18个月,骨折均愈合。根据踝关节功能Mazur评价标准:优4例,良5例,可1例,差1例,优良率81.8%。结论根据老年Pilon骨折特点,充分的术前准备,采用合适的内固定治疗,利于早期进行功能锻炼,减少术后并发症的发生,提高老年患者生活质量。

Objective To explore the methods and efficacy with locking plate in the treatment of the senile Pilon fractures.Methods This retrospective research related to 11 patients with Pilon fractures treated by locking plate.According to Müller AO classification system,there were 2 cases of type B2,1 case of type B3,3 cases of type C,2 cases of type C2 and 3 cases of type C3.According to Ruedi-Allgower type,there were 2 cases of typeⅠ,5 cases of typeⅡ and 4 cases of typeⅢ.All the patients were treated by using open reduction and locking plate fixation after contraindication was excluded.Results All the patients were followed up from 13 to 25 months（average of18 months）,and all fractures healed.According to the Mazur score system for ankle function,4 patients were excellent,5 were good,1 was fair and 1 was poor.The rate of excellent and good was 81.8%.Conclusion According to characteristics of the senile Pilon fracture,sufficient preoperative preparation and appropriate internal fixation could be benificial to early exercise,reduce complications and improve the life quality of the elderly.