摘要
目的探讨青少年Pilon骨折的特点、治疗方法及其并发症。方法对1990年4月～2003年12月期间治疗的13例青少年胫骨Pilon骨折病例进行随访分析。按Merv-Letts分型:Ⅰ型5例,Ⅱ型6例,Ⅲ型2例。骨牵引治疗2例,有限内固定8例,有限内固定结合外固定支架3例。结果所有患者平均随访24个月,按Helfet踝关节功能评价:优8例,良4例,差1例,优良率92.3%。并发症:皮肤坏死2例,创伤性关节炎4例,骨骺早闭3例,畸形愈合1例,骨延迟愈合1例,外固定支架钉道感染1例,总体并发症38.5%。结论青少年Pilon骨折应根据其分型采用不同的治疗方案;疗效与创伤程度有关;Ⅲ型骨折有较高的并发症。
Objective To investigate the characteristics, treatment and complications of adolescent tibial Pilon fractures. Methods 13 cases of adolescent tibial Pilon fractures were treated in our department from 1990 to 2003. They were followed up for an average period of 24 months. According to Merv-Letts classification system, there were 5 cases of type Ⅰ, 6 cases of type Ⅱ, and 2 cases of type Ⅲ. 2 cases were treated with skeletal calcaneal traction, 8 cases with open reduction and limited internal fixation, and 3 cases with limited internal fixation combined with external fixation. Results Their ankle functions were evaluated according to the Helfet criteria. 8 cases were rated as excellent, 4 as good, and 1 as poor. The excellent and good rate was 90.9%. 2 cases experienced skin necrosis, 4 cases posttraumatic osteoarthritis, 3 cases epiphyseal arrest, 1 case malunion, 1 case delayed union, and 1 case minor pin-tract infection. No osteomyelitis or nonunion happened. The total rate of complications was 38.5%. Conclusions Proper measures should be taken according to the different types of skeletally immature adolescent Pilon fracture. Results are associated with severity of trauma and fracture types. Type Ⅲ fractures are associated with a high complication rate.
出处
《中华创伤骨科杂志》
CAS
CSCD
2005年第9期833-836,共4页
Chinese Journal of Orthopaedic Trauma
