急诊使用三维外固定架对Rüedi-Allgwer Ⅲ型Pilon骨折的关节面复位的临床研究

Clinical Study on the Reduction of the Articular Surface of the Rüedi-Allgwer Ⅲ Pilon Fracture Using the Three-dimensional External Fixator

目的探讨在急诊情况下使用三维外固定架对Rüedi-AllgwerⅢ型Pilon骨折的关节面复位的临床研究。方法方便选取该院2012年5月—2016年8月收治的Rüedi-AllgwerⅢ型Pilon骨折的患者,在急诊早期使用三维外固定架进行骨折的复位;所有患者34例,其中男20例,女14例;年龄16~62岁,平均(42.6±0.2)岁;软组织条件允许后,二期行内固定手术治疗。采用评价骨折在影像学上复位标准的Burwell-Charnley标准和美国足踝外科协会AOFAS踝-足评分系统进行功能评价。结果随访32例,2例失联,随访12~24个月,平均14个月,结果为Burwell-Charnley标准:关节面复位优良患者优20例,良12例,差2例。AOFAS踝-足评分系统(总分100分):该组优25例,良4例,可3例。结论在急诊情况下使用三维外固定架对Rüedi-AllgowerⅢ型Pilon骨折的胫骨关节面复位有良好的效果,能帮助二期手术时关节面的复位,并能大幅度缩短二期内固定手术的手术时间,对骨折愈合及踝关节远期效果有明显的提高。

Objective This paper tries to investigate the clinical study of the reduction of the articular surface of the Rüedi-AllgowerⅢPilon fracture using the three-dimensional external fixator in emergency.Methods From May 2012 to August 2016,34 patients with Pilon fractures of Rüedi-Allgower type III in the early emergency using three-dimensional external fixator for fracture reduction;There were 20 males and 14 females,aged 16~62 years,with an average age of(42.6±0.2)years;After waiting for the soft tissue condition,the two stage was treated with internal fixation.We recorded the reduction of ankle joint surface,using Burwell-Charnley standard to evaluate fractures in the imaging reduction standard and AOFAS Ankle foot scoring system(total score 100 points)was used to evaluate.Results 32 cases were followed up,and 2 cases were of loss of association for 12 to 24 months,an average of 14 months,the results of the Burwell-Charnley criteria:superior surface reduction in patients with excellent in 20 cases,good in 12 cases and poor in 2 cases.AOFAS ankle-foot score system(total score of 100 points):this group was excellent in 25 cases,good in 4 cases,and poor in 3 cases.Conclusion The use of three-dimensional external fixator in the emergency case of the Rüedi-AllgowerⅢPilon fracture of the tibial articular surface reduction has a good effect,can help the second phase of the reduction of articular surface and can significantly shorten the two fixed surgery surgery Time,fracture healing and ankle joint long-term effect has been significantly improved.