手术治疗Pilon骨折64例临床分析

摘要

Objective To analyze suitable surgical method and clinical curative effect in treatment of Pilon fractures. Methods A retrospective analysis of 64 consecutive cases were conducted. According to Rüedi-Allg(o)wer tibial Pilon fracture classification ,8 were of type Ⅰ ,44 type Ⅱ and 12 type Ⅲ . During operation ,23 cases were treated with open reduction in tibia lower extreme and internal fixation with plates ,25 cases had close reduction and internal fixation with minimally invasive percutsneous plate osteosynthesis , 16 cases were treated with open reduced minimally and external fixation with plaster. Results The average piriod of follow-up was 22 mothes. Accordiong to Mazur's criteria, the result was evaluated as excellent in 33 cases ,good in 19 cases , fair in 7 cases , and poor in 5 cases. Conclusion Good timing of operation and correct surgery method are the key points to improve the efficacy of Pilon fractures and reduce complicating disease.%目的 探讨治疗Pilon骨折合适的手术方法及其临床疗效. 方法 通过不同的手术方法治疗Pilon骨折并获得有效随访患者64例,根据Rüedi-Allgwer骨折分型;Ⅰ型8例,Ⅱ型44例,Ⅲ型12例,23例行骨折切开复位胫骨下端解剖钢板内固定,25例用微创经皮钢板内固定技术锁定加压钢板钢板内固定术,16例行有限内固定结合外固定. 结果 64例患者平均随访22个月,采用Mazur评价标准,优33例,良19例,中7例,差5例.优良率为81.25%. 结论 选择适当的手术时机,正确的手术方法,是提高Pilon骨折手术疗效和降低并发症的关键.