目的 探讨解剖型锁定钢板结合克氏针、螺钉治疗严重Pilon骨折的体会.方法 对2011年3月至2015年6月收治的23例严重Pilon骨折患者资料进行回顾性分析.结果 本组全部病例均进行回访,时间5~16个月,平均12.5个月.优13例,良5例,可3例,差2例,总有效率为91.3%.2例患者术后出现创口表浅皮肤坏死感染,经换药后痊愈,未发生内固定物断裂,皮瓣严重坏死及骨折再移位和骨折不愈合.结论 对于严重Pilon骨折在治疗前术者应对软组织的损伤情况进行充分完整的评估,根据骨折及软组织情况合理选择手术时机及术后科学指导患者功能锻炼,使患者能达到有效的康复.%Objective To explore the experience of anatomical locking plate combined with Kirschner wire and screw in the treatment of severe Pilon fracture. Methods The data of 23 patients with severe Pilon fractures admitted in our hospital from March 2011 to June 2015 were retrospectively analyzed. Results All the patients were followed up for 5 months to -16 months,with an average of 12.5 months,excellent in 13 cases,good in 5 cases,fair in 3 cases and poor in all cases,with a total effective rate of 91.3%. Superficial skin necrosis,wound infection occurred in two patients,the cure after treatment,no breakage of internal fixation,flap necrosis and severe fracture displacement and nonunion of fracture. Conclusion For severe Pilon fractures in patients before treatment to injury of soft tissue are evaluated according to fully complete, reasonable choice of surgical timing and postoperative scientific guidance for functional exercise of patients with fracture and soft tissue,so that patients can achieve effective rehabilitation.
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