胫骨Pilon骨折治疗方法探讨
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刘春杰 LIU Chun-jie 临汾市第六人民医院骨科,山西 临汾 041000 Department of Orthopaedics,the 6th People's Hospital of Linfen City,Linfen 041000,Shanxi,China liuchunjie1968@126.com 
张伟增 ZHANG Wei-zeng 临汾市第六人民医院骨科,山西 临汾 041000 Department of Orthopaedics,the 6th People's Hospital of Linfen City,Linfen 041000,Shanxi,China  
褚鹏程 ZHU Peng-cheng 临汾市第六人民医院骨科,山西 临汾 041000 Department of Orthopaedics,the 6th People's Hospital of Linfen City,Linfen 041000,Shanxi,China  
期刊信息:《中国骨伤》2010年,第23卷,第2期,第128-130页
DOI:10.3969/j.issn.1003-0034.2010.02.016
基金项目:
中文摘要:

目的:探讨胫骨Pilon骨折最佳手术方法、恰当手术时机及手术疗效。

方法:1999年3月至2008年11月收治52例Pilon骨折患者,男38例,女14例;年龄23~59岁,平均38岁。开放性骨折17例,闭合性骨折35例。根据Ruedi-Allgower分型:Ⅰ型6例,Ⅱ型29例,Ⅲ型17例。急诊手术33例,择期手术19例,伤后至手术时间平均8.3 d.根据骨折类型分别采取切开复位三叶形钢板内固定、有限内固定结合外支架固定等不同的手术方法治疗。

结果:所有病例获得随访,随访时间10~55个月,平均28个月,骨折均愈合。按Mazur评价标准,优28例,良14例,可10例。术后皮肤软组织感染、坏死5例;骨折不愈合 1例再次手术植骨后愈合;晚期发生踝关节创伤性关节炎6例。

结论:根据骨折类型、损伤程度及时有效地采取恰当的手术治疗是取得满意疗效的关键,可有效避免并发症的发生。
【关键词】胫骨骨折  外科手术  骨折固定术,内
 
Surgical treatment of tibia Pilon fractures
ABSTRACT  

Objective: To evaluate the choice of operative method,timing of surgery and the outcome of tibia Pilon fractures.

Methods: From March 1999 to November 2008,52 patients of Pilon fractures were treated including 38 males and 14 females with the average age of 38 years old ranging from 23 to 59 years. There were 17 cases of open fractures and 35 cases of closed fractures. According to Ruedi-Allgower type,there were 6 cases of typeⅠfracture,29 cases of type Ⅱ,17 cases of type Ⅲ。 Thirty-three cases selected emergency surgery and 19 cases selected the selective operation,the average period between injury and surgery was 8.3 days. According to the type of fracture,open reduction and plate fixation of Trilobal,limited internal fixation combined with external fixation were applied for treatment of different surgical methods.

Results: All patients were followed-up for from 10 to 55 months(averaged 28 months). According to Mazur's criterion,the result of treatment was evaluated as excellent in 28 cases,good in 14 and fair in 10. After operation,5 cases occurrenced skin and soft tissue infection and necrosis,1 case of nonunion healed again after bone graft in re-operation,6 patients occurrenced ankle traumatic arthritis later.

Conclusion: According to fracture type,degree of injury and timely and effective surgical treatment is the key to achieve a satisfactory effect,which can effectively avoid the occurrence of complications.
KEY WORDS  Tibial fractures  Surgical procedures,operative  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:刘春杰,张伟增,褚鹏程.胫骨Pilon骨折治疗方法探讨[J].中国骨伤,2010,23(2):128~130
英文格式:LIU Chun-jie,ZHANG Wei-zeng,ZHU Peng-cheng.Surgical treatment of tibia Pilon fractures[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(2):128~130
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