复杂Pilon骨折的围手术期管理及手术治疗

Perioperative Management and Surgical Treatment of Complex Pilon Fractures

目的探讨复杂Pilon骨折的围术期有效管理方法及手术疗效。方法选取我院2012年1月—2016年12月收治的II,III型Pilon骨折患者95例作为研究对象。全部患者均基于AO原则于适当时机行切开复位钢板内固定治疗,术前积极改善局部软组织条件,术后预防皮肤坏死,早期个性化康复锻炼。术后随访,统计患者疗效及并发症。结果手术治疗优58例,良19例,优良率81.05%;在围术期有7例患者出现并发症,术后随访有4例患者出现并发症,发生率11.58%。结论以切开复位钢板内固定治疗复杂Pilon骨折临床疗效良好,术前加强皮肤软组织管理、适时把握手术时机、术后早期功能锻炼有助于减少并发症,降低病残率。

Objective To explore the effective management of perioperative period of complex Pilon fractures and the curative effect. Methods From January 2012 to December 2016, 95 patients with type II and III Pilon fractures were enrolled in this study. All patients were based on the principle of AO at the appropriate time to cut open plate internal fixation treatment, preoperative and actively improve the local soft tissue conditions, postoperative prevention of skin necrosis, early personalized rehabilitation exercise. Statistics of patients with efficacy and complications. Results 58 cases were excellent in operation and 19 cases were good. The excellent and good rate was 81.05%. There were 7 cases of patients with the complication in perioperative period and 4 cases of postoperative follow-up. The incidence rate was 11.58%. Conclusion The effective treatment of complex Pilon fractures with open reduction and internal fixation is effective. The early functional exercise can help reduce the complication and reduce the disease rate.