目的：探讨使用内侧锁定钢板与前侧“T”型钢板联合固定在C3型Pilon骨折中的临床应用效果。方法本院自2011年4月至2013年11月对11例C3型Pilon骨折患者采用内侧锁定钢板结合前侧“T”型钢板联合固定，治疗后观察骨折愈合、踝关节功能及术后相关并发症发生情况。结果全部患者均获得22~26个月的随访，平均（24±2）个月。所有患者骨折均达临床愈合，骨折愈合时间为12~16周，平均（13.5±1.4）周。末次随访按Mazur踝关节功能评分系统对患者的踝关节功能进行评分：优8例，良3例。术后患侧踝关节跖屈活动度为39.2°±1.8°，健侧为40.9°±2.2°。术后患侧踝关节背伸活动度为21.5°±1.8°，健侧为22.9°±1.7°。患侧与健侧比较差异均无统计学意义（均P＞0.05）。所有患者无术后相关并发症发生。结论采用内侧锁定钢板与前侧“T”型钢板联合固定C3型Pilon骨折，术后患者骨折均达临床愈合，且踝关节功能恢复正常，无术后相关并发症发生，该术式临床应用效果满意，值得推广。%Objective To evaluate the clinical effects of the medial locking plate and the anterior T type plate in the treatment of Pilon fractures of type C3. Methods Eleven patients with Pilon fractures of type C3 were chosen from April 2011 to November 2011. All of them were treated by open reduction and internal fixation with the medial locking plate and the anterior T type plate. The outcomes of fracture healing and complications were observed. The ankle functions were evaluated according to the Mazur ankle performance index. Results During the average follow⁃up period of (24±2) months, fractures in all patients healed. Frac⁃ture healing time was (13.5±1.4) weeks for those patients. According to the Mazur ankle performance index at last visit, the treatment in 8 patients showed excellent outcomes and three showed well. The flexibility of moving forward and backward for the treated ankle was 39.2° ± 1.8° and 21.5° ± 1.8° respectively, which had no statistically significant difference comparing to the other side (40.9°±2.2°, and 22.9°±1.7°, P>0.05). There was no evidence of the post⁃operation complications. Conclusion After receiving the treatment of medial locking plate and the anterior T type plate for Pilon fracture of type C3, patients had a fully recovery on both fracture and function without suffering any related complications. The treatment reaches a successful clinical outcome, which is worth using widely.
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