单臂外固定支架在Pilon骨折中的应用

The Use of Single Arm Universal Unilateral External Fixator in Pilon's Fracture

目的探讨单臂外固定支架治疗Pilon骨折的可行性及结果。方法 10例Pilon骨折(AO分型,C3)以单臂外固定支架治疗,男性8例,女性2例,年龄21～54岁,平均35岁。所有病例腓骨骨折均切开复位内固定,然后在C臂机监视下经皮克氏针撬拨复位胫骨关节面,用单臂万向外固定支架行胫距或胫跟固定。结果平均随访16月,结果优5例,良4例,可1例,优良率达90％.骨折平均临床愈合时间14周,无骨不连、骨坏死、关节强直、关节不稳等并发症发生。结论单臂万向外固定支架治疗Pilon骨折具有手术方法简单,创伤小。手术及时,时间短,可早期功能锻炼,特别对于开放骨折有特殊意义。

Objective To investigate the use of single arm universal unilateral external fixator in Pilon's fracture. Methods Ten cases (8 men and 2 women) with Pilon's fractures,treated by single arm universal unilateral external fixator, were reviewed.The average age of the patients was 35 years (range,21 years to 54 years) .Open reduction and internal fixation were performed for all fibular fractures before the distal articular surfaces of the tibias were reconstructed percutaneously by leverage of Kirschner wires. After reduction the tibiocalcaneal or talotibial joints were fixed by Bastiani unilateral external fixator. Results The average length of follow - up was 16 months. Results were good to excellent in 90.0% of cases, in which 6 cases were excellent,4 good,l fair. Fractures healed within an average length 14 weeks. No complications, such as nonunion, bone necrosis, stiffness and ankle instability, were observed. Conclusion External fixation with single arm universal unilateral external fixator offers advantages in the treatment of Pilon' s fractures, which is simple, minimally invasive to soft tissue and provides immediate operation and early motion exercise. This technique appears to be much more effective in open fractures.