摘要
目的比较3种方法治疗高能量Pilon骨折的临床效果.方法自1995年～2004年共收治高能量Pilon骨折患者95例,均属Ruedi和AllgowerⅡ,Ⅲ型.按治疗方法不同分为3组:即采用AO苜蓿叶形钢板内固定32例为A组;有限内固定结合'T'形超关节外固定架治疗30例为B组;短期外固定架固定后改用钢板内固定33例(即两阶段法)为C组.结果经10个月～8年的随访(平均2.4年),按Teeny和Wiss评分系统,A组临床疗效优良率为65.63%,并发症发生率为26.5%;B组临床疗效优良率为60.00%,并发症发生率为30.5%;C组临床疗效优良率为84.85%,并发症发生率为22.5%.结论三种方法可用于高能量Pilon骨折的治疗,其中两阶段治疗法疗效较佳.
Objective To evaluate prospectively the outcomes of the treatment of severe Pilon fractures with three different fixation system. Methods 95 cases suffered from severe Pilon fractures, Results After an average 2.4 years of follow-up ranging from 10 months to 8 years, the rate of both the excellent and good of the outcomes of the treatment of severe Pilon fractures with three different fixation system protocol according to Teeny-Wiss Score System, in group A,B and C were 65.63%, 60.00%, and 84.85%. The rate of complieatlons happening, in group A,B and C were 26.5%, 30.5% and 22.5% , Among the three groups, the rate of both the excellent and good of the outcomes of group C were the highest and the difference between group A, B and C had not statistical significance （P〉0.05） . The difference between group B and C had statistical significance （P〈0.05） . Conclusion The three different treatment protocols are appropriate for treatment of severe Pilon fractures after trauma, especially the twe-staged protocol can get better outcomes than the other techniques.
关键词
PILON骨折
外同定
内固定
两阶段治疗法
Pilon fraeture
External fixation
Internal fixation
Two-staged technique
