Ⅱ、Ⅲ型Pilon骨折的治疗策略  

The Tactics of Treating the Type Ⅱ and Ⅲ Pilon Fracture

作　　者：毛伟民[1] 张经伟[1] 

机构地区：[1]浙江省宁波市第六医院,浙江宁波315040

出　　处：《实用骨科杂志》2007年第12期718-719,共2页Journal of Practical Orthopaedics

摘　　要：目的探讨治疗Ruedi-AllgowerⅡ、Ⅲ型Pilon骨折的治疗方法。方法采取切开复位内固定或有限切开内固定结合外固定的两种治疗方法治疗Pilon骨折42例。结果优20例,其中型12例,型8例;良16例,其中Ⅱ型4例,Ⅲ型12例;可5例,差1例,优良率85.7%。结论腓骨长度的恢复和解剖复位,胫骨远端关节面骨折的解剖复位,干骺端骨缺损松质骨植骨及尽可能的坚强固定,踝关节的早期活动是治疗Pilon骨折的关键。影响Pilon骨折疗效的因素,不仅是骨折的整复固定,更重要的是如何避免局部软组织的有关并发症。Objective To explore the effective way to treat the Ruedi-Allgower type Ⅱ and Ⅲ Pilon fracture. Methods 42 cases of Pilon fractures were treated with open reduction and internal fixation or with limited open reduction,internal fixation and external fixation. Results Excellent 20 cases（type Ⅱ 12 cases,type Ⅲ 8 cases）,Good 16 cases （type Ⅱ 4 cases,type Ⅲ 12 cases）,Mild 6 cases,Bad 1 case. The rate of excellent and good was 85.7%. Conclusion The key to treat the Pilon fracture was restoration of length and anatomic reduction of fibula,the anatomic reduction of distal tibial joint ,bone grafting of metaphysic ,rigid internal fixation and early activity of ankle. The influential factors of the results of treating Pilon fractures were the techniques to avoid the complications of the surrounding soft tissue and the reduction and fixation of the fracture.

关 键 词：PILON骨折 内固定 外固定 

分 类 号：R683.42[医药卫生—骨科学]