摘要
目的探讨跟骨牵引或外固定支架在分期治疗高能量Pilon骨折中的作用。方法 2003年2月至2011年8月共收治46例高能量Pilon骨折患者,男性32例,女性14例,年龄22～58岁,平均46.2岁。一期治疗行跟骨牵引28例,外固定支架18例。待患者全身情况好转、创面愈合或软组织条件改善后,二期行切开复位内固定术。结果 28例跟骨牵引平均使用时间为8.9 d(4～11 d),18例外固定支架平均使用时间为12.2 d(11～52 d),二期均转为内固定。除1例发生钉道感染外,其他病例软组织开放伤口及手术伤口未见感染。所有病例均获得骨性愈合,未见其他并发症。结论高能量Pilon骨折治疗中以骨科损伤控制为原理,一期采用跟骨牵引或外固定支架,二期更换为内固定之分期治疗方法是安全有效的。
Objective To evaluate the significance of skeletal traction or external fixation in the staged management of high energy Pilon fractures. Methods Forty-six patients with Pilon fractures were surgically treated from February 2003 to August 2011 in our hospital. There were 32 males and 14 females. The average age was 46. 2 years （range, 22 to 58 years）. All patients were treated with skeletal tractions or external fixators at the first aid. Then it was secondly replaced by open reduction and internal fixation when the patients＇ general conditions were controlled, and the local status of soft tissues was improved. Results The mean duration of the skeletal tractions were 8.9 days （range, 4-11 days） and the external fixation was I2. 2 days （range, 11-52 days）. All the wounds and incisions were healed without any infections except one case. It was treated with external fixation and infection was found. It was controlled by antibiotics and local gentamyein-released beads for 7 weeks, and got recovery finally. All the cases obtained bony union. No other complications were found in this study. Condusion It is safe and effective for high -energy Pilon fractures to be treated with the staged management according to the principles of damage control orthopedics.
出处
《国际骨科学杂志》
2012年第2期132-133,149,共3页
International Journal of Orthopaedics
