三种内固定方法治疗Pilon骨折疗效分析  

Three Surgical Approaches to Pilon Fracture

作　　者：刘国龙[1] 窦庆寅[1] 蔡卫东[1] 阳闽军[1] 韩同坤 

机构地区：[1]广东省深圳市宝安区松岗人民医院骨科,518105

出　　处：《中华全科医学》2011年第7期1075-1075,1084,共2页Chinese Journal of General Practice

摘　　要：目的通过对Ruedi-Allgowe PilonⅡ型和Ⅲ型骨折的三种手术治疗方式疗效分析,以期找到Pilon骨折更为科学的治疗方法。方法选取2000年1月-2010年4月期间采用三种手术方法（单纯克斯针螺钉内固定、胫骨远端解剖锁定钢板、外固定支架结合有限内固定）治疗的Pilon骨折67例患者回访资料并进行分析。结果术后随访时间6-47（24±5）个月。骨折复位情况按Burwell Charnley放射学评价标准：复位良好：Ⅱ型32例,Ⅲ型27例。复位欠佳：Ⅱ型2例;Ⅲ型6例。临床疗效按AOFAS踝与足功能评分：优34例（90-100分）;良25例（75-89分）;一般6例（50-74分）;差2例（50分）。结论手术时机及内固定器材的选择是Pilon骨折治疗成功的关键。胫骨远端解剖锁定钢板可作为手术治疗Pilon骨折内固定器材的首选。Objective To analyze the effects of three surgical operations to Ruedi-Allgowe Pilon typeⅡ and Ⅲ fracture in hope to improve the treatment of Pilon fractures.Methods The clinical data of 67 patients with Pilon fracture who received surgical operations（Kirschner wires internal fixation,distal tibia anatomical plate,external fixation with limited internal fixation） from January 2000 to April 2010 were analyzed.Results All patients were followed up for 6 to 47（24±5） months.According to Burwell Charnley criteria,the effect of fracture replacement was 59 good（type Ⅰ 32 cases,type Ⅲ 27 cases） and 8 bad（type Ⅱ 2 cases,type Ⅲ 6 cases）.According to American Foot and Ankle Society（AOFAS） ankle and foot function score,the function of ankle and foot were excellent in 34 cases（90-100 points）,good in 25 cases（75-89 points）,fair in 6 cases（50-74 points） and bad in 2 cases（50 points）.Conclusion The time of surgery and the internal fixator are the key of Pilon fracture operation.The distal tibia anatomical plate is a preferable internal fixator.

关 键 词：PILON骨折 手术时机 内固定器材 

分 类 号：R683.423[医药卫生—骨科学]