切开复位内固定治疗后Pilon骨折疗效分析

Surgical Intervention of Open Reduction and Internal Fixation for Posterior Pilon Fractures

目的探讨手术治疗后 Pilon 骨折的临床疗效。方法 2016 年 1 月~ 2017 年 12 月我院收治后 Pilon 骨折患者 9 例,其中Ⅰ型 4 例,Ⅱ型 3 例,Ⅲ型 2 例,均行切开复位内固定术。结果本组 9 例患者均获得随访,平均随访时间 17.2( 12~ 24)个月,均获得骨性愈合,平均骨折愈合时间 7.1( 3 ~ 12)个月。8 例伤口一期愈合,1 例伤口延迟愈合,经换药处理后愈合良好。采用 AOFAS 的踝关节-后足评分标准进行疗效评估,平均 81.8( 63~95 )分。末次随访时 2 例患者出现了创伤性关节炎,踝关节活动轻度受限,长距离行走疼痛。结论切开复位内固定手术治疗后 Pilon 骨折效果确切,术后可早期功能锻炼,并发症少。

Objective To explore the clinical effect of surgical treatment of posterior Pilon fractures. Method The clinical data of 9 cases with posterior Pilon fractures treated by open reduction and internal fixation from January 2016 to December 2017 in our hospital were analyzed retrospectively,including 4 cases of type Ⅰ, 3 cases of type Ⅱ and 2 cases of type Ⅲ. Results All 9 cases were followed up for 12 to 24 months with an average of 17.2 months.Bone union was achieved in all cases during 3 to 12 months ( average 7.1 months).Eight cases gained the wound healing in one stage,and one case was found wound delayed healing and healed well after dressing change. According to the Ankle & Hindfoot scale of American Orthopaedic Foot and Ankle Society ( AOFAS),the mean score was 63 to 95 with an average of 81.8.At the last follow-up,2 patients developed traumatic arthritis. Conclusion The surgical intervention of open reduction and internal fixation can achieve an reliable effect for posterior Pilon fractures with early postoperative functional exercise and fewer complications.