摘要
目的 探讨高能量劈裂骨折（Pilon）的适宜手术方法、手术时机。方法 对1998～2004年接受手术治疗的56例高能量Pilon骨折治疗进行回顾性分析。Ⅱ型骨折35例，Ⅲ型21例；21例行国外骨折内固定技术（AO）切开复位内固定术，16例行有限内固定结合外固定支架，19例行分步和延期两阶段分步治疗（ORIF）治疗，术后平均随访34个月。结果 采用Mazur评分系统评估手术疗效，优24例，良20例，优良率78．6％。术后并发症包括创面不愈合4例，术后感染2例，延迟愈合1例，关节退行性变10例。结论 充分的术前准备和计划，根据骨折类型和软组织条件，灵活选择不同的手术治疗方法是取得良好治疗效果的关键。
Objective To study for the proper operative method, timing of surgery of severe pilon fracture. Methods Fifty-six patients with severe Pilon fracture operatively treated between 1998 to 2004 were followed up. According to the Ruedi-Allgower classification, there were 35 cases of type Ⅱ fracture and 21 cases of type Ⅲ fracture. During operation,21 patients had the fractures reduced and internal fixation was done,16 patients had limited open reduction and coupled with internal fixation, 19 patients had been treated with two-stage operation ,and delayed ORIF. The average period of follow - up of these 56 patients was 34 months. Results According to Mazur＇s Criterion, the result of the treatment was excellent in 24 patients, good in 20 patients, the total percent of excellent and good outcome was 78.6%. No poor result was found. Complications included wound dehiscense in 4 cases, infection in 2 cases,delayed union of fracture 1 case and late degenerative changes of the ankle joint in 10 cases. Conclusion The satisfactory clinical outcome of tibial severe pilon fracture depends upon the choice of a proper operative treatment according to different types of fractures and soft tissues injured and proper operative preparation and well planned operation.
出处
《创伤外科杂志》
2006年第3期212-214,共3页
Journal of Traumatic Surgery
关键词
骨折
手术
内固定
fracture
operation
internal fixation
