Objective To explore the efficacy of sequential surgery for high-energy Pilon fractures. Methods 36 patients underwent sequential surgery for high-energy Pilon fractures. They received reduction and internal fixation of fibular fracture plus traction of calcaneus for primary treatment 10 to 14 days after the first treatmnt, they received reduction and internal fixation of tibia]articular surface for secondary treatment. The time from fracture occurrence to surgery on tibial articular surface was 10 to 14 days, with an average of 12 days. Results 32 patients were followed up for 8 to 36 months (mean time, 17.3 months). According to the system for scoring and function of the ankle joint by Mazur, 18 patients had an excellent result, 9 better result, 4 receptible result, and 1 bad result, with an ideal outcome rate of 84.3%.Conclusions Sequential surgery is beneficial in reducing edema in the tissue and returning the tibial articular surface to its correct position by the secondary surgery, and it can reduce the incidence of postoperative complications including infection and skin necrosis.%目的 探讨应用分期手术治疗高能量Pilon骨折的临床疗效方法 36例高能量Pilon骨折应用分期手术治疗,患者人院后一期行腓骨骨折切开整复内固定及跟骨牵引,10～14天软组织情况改善后二期行胫骨关节面整复固定.伤后至胫骨关节面手术时间为10～14天,平均12天.结果 32例患者获得随访8～36个月,平均17.3个月,采用Mazur等提出的踝关节症状与功能评分系统进行评分,优18例,良9例,可4例,差1例,优良率84.3%.结论 分期手术有利于消肿及二期手术时胫骨关节面的复位,可降低术后感染及皮肤坏死等并发症的发生.
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