胫骨Pilon骨折的外科治疗
[Surgical treatment of tibia Pilon fractures].
作者信息
Liu Chun-jie, Zhang Wei-zeng, Zhu Peng-cheng
机构信息
Department of Orthopaedics, the 6th People's Hospital of Linfen City, Linfen 041000, Shanxi, China.
出版信息
Zhongguo Gu Shang. 2010 Feb;23(2):128-30.
OBJECTIVE
To evaluate the choice of operative method,timing of surgery and the outcome of tibia Pilon fractures.
METHODS
From March 1999 to November 2008, 52 patients of Pilon fractures were treated including 38 males and 14 females with the average age of 38 years old ranging from 23 to 59 years. There were 17 cases of open fractures and 35 cases of closed fractures. According to Ruedi-Allgower type,there were 6 cases of type I fracture, 29 cases of type II, 17 cases of type III. Thirty-three cases selected emergency surgery and 19 cases selected the selective operation, the average period between injury and surgery was 8.3 days. According to the type of fracture, open reduction and plate fixation of Trilobal, limited internal fixation combined with external fixation were applied for treatment of different surgical methods.
RESULTS
All patients were followed-up for from 10 to 55 months (averaged 28 months). According to Mazur's criterion, the result of treatment was evaluated as excellent in 28 cases,good in 14 and fair in 10. After operation, 5 cases occurrenced skin and soft tissue infection and necrosis, 1 case of nonunion healed again after bone graft in re-operation, 6 patients occurrenced ankle traumatic arthritis later.
CONCLUSION
According to fracture type, degree of injury and timely and effective surgical treatment is the key to achieve a satisfactory effect, which can effectively avoid the occurrence of complications.
目的
评估胫骨Pilon骨折的手术方法选择、手术时机及治疗效果。
方法
1999年3月至2008年11月,共治疗52例Pilon骨折患者,其中男性38例,女性14例,平均年龄38岁(23~59岁)。开放性骨折17例,闭合性骨折35例。按Ruedi-Allgower分型,Ⅰ型骨折6例,Ⅱ型29例,Ⅲ型17例。33例行急诊手术,19例行择期手术,受伤至手术平均时间为8.3天。根据骨折类型,分别采用三叶形钢板切开复位内固定、有限内固定结合外固定等不同手术方法治疗。
结果
所有患者随访10~55个月(平均28个月)。按Mazur标准评估,治疗结果优28例,良14例,可10例。术后发生皮肤及软组织感染坏死5例,1例骨不连再次手术植骨后愈合,6例后期出现踝关节创伤性关节炎。
结论
根据骨折类型、损伤程度及时有效的手术治疗是取得满意疗效的关键,可有效避免并发症的发生。