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切开复位内固定治疗胫骨Pilon骨折的临床结果

[Clinical results of tibial pilon fractures treated by open reduction and internal fixation].

作者信息

Kalenderer Onder, Güneş Osman, Ozçalabi I Türkay, Ozlük Serkan

机构信息

Izmir SSK Tepecik Eğitim Hastanesi II. Ortopedi ve Travmatoloji Kliniği.

出版信息

Acta Orthop Traumatol Turc. 2003;37(2):133-7.

Abstract

OBJECTIVES

We evaluated the results of pilon fractures treated by open reduction and internal fixation.

METHODS

The study included 18 patients (mean age 36 years; range 19 to 56 years) with pilon fractures. According to the Ruedi and Allgower's classification, there were three type I, nine type II, and six type III fractures. Five fractures were open including three of Gustilo-Anderson type II, and two fractures of type III. The results were assessed using the Burwell-Charnley criteria. The mean follow-up was 54 months (range 9 to 86 months).

RESULTS

According to the Burwell-Charnley criteria, the results were good in 12 patients (66%), fair in three patients (17%), and poor in three patients (17%). The most common complication was posttraumatic degenerative arthritis, followed by wound infection (22%), Sudeck atrophy (22%), delayed union (17%), and angulation (11%).

CONCLUSION

Early anatomical reduction, a stable fixation, early mobilization, and delayed weight-bearing seem to improve long-term results of treatment in pilon fractures caused by high energy trauma.

摘要

目的

我们评估了切开复位内固定治疗pilon骨折的结果。

方法

该研究纳入了18例pilon骨折患者(平均年龄36岁;范围19至56岁)。根据Ruedi和Allgower分类,有3例I型骨折、9例II型骨折和6例III型骨折。5例骨折为开放性骨折,包括3例Gustilo-Anderson II型骨折和2例III型骨折。采用Burwell-Charnley标准评估结果。平均随访时间为54个月(范围9至86个月)。

结果

根据Burwell-Charnley标准,12例患者(66%)结果良好,3例患者(17%)结果一般,3例患者(17%)结果较差。最常见的并发症是创伤后退行性关节炎,其次是伤口感染(22%)、Sudeck萎缩(22%)、延迟愈合(17%)和成角畸形(11%)。

结论

早期解剖复位、稳定固定、早期活动和延迟负重似乎可改善高能创伤所致pilon骨折的长期治疗结果。

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