Pilon骨折的CT分型及其临床指导意义  

Classification of Pilon fractures by computed tomography and its guide to clinical treatment

作　　者：贾斌[1] 张勇[1] 李郑林[1] 曹国庆[1] 刘彦勋[1] 

机构地区：[1]深圳平乐骨伤科医院创伤骨科,广东深圳518000

出　　处：《中国骨伤》2011年第6期470-473,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:介绍一种Pilon骨折的三柱分型方法及其分柱固定治疗,评价其临床疗效。方法:2007年6月至2010年3月采用"三柱分型"及分柱固定治疗Pilon骨折27例29踝,男26例,女1例;年龄23～59岁,平均33.1岁。根据三柱分型选择手术入路及内固定方法,采用前内侧、前侧、后外侧、后内侧等入路进行显露,以1/3半管形钢板或螺钉分柱固定,术后随访评价临床效果。结果:随访时间5～33个月,平均17.5个月。按Mazur标准:优20踝,良4踝,可5踝。2踝部分皮缘坏死切口延迟愈合,经清洁换药后愈合,无创口裂开、深部感染、骨髓炎、骨不连、关节僵硬及关节不稳等并发症,无因创伤性关节炎而行关节融合术。结论:基于三柱理论进行Pilon骨折的分型及分柱固定,使Pilon骨折的治疗更具条理性,治疗方法的选择更为可靠。Objective：To introduce a method of three-column classifications for Pilon fractures and observe clinical utility on column fixation.Methods：From June 2007 to March 2010,a total of 27 patients（29 ankles,26 males and 1 female,ranging in age from 23 to 59 years,with an average of 33.1 years） with Pilon fractures were treated through column fixation by using semitubular plates or screws with anteromedial,anterior,posterolateral,posteromedial approach.And postoperative follow up were carried out.Results：The mean follow up was 17.5 months（ranged,5 to 33 months）.According to the Mazur ankle grading system,the outcome was excellent in 20,good in 4 and fair in 5 ankles.Patients in this group did not have complications of wound dehiscence,deep infection,osteomyelitis,nonunion,ankylosis,and joint instability.Conclusion：Based on the three-column classification,the clinical results for the treatment of Pilon fractures demonstrate the rationality and efficiency of this method.

关 键 词：PILON骨折 骨折固定术 内 骨科手术方法 体层摄影术 X线计算机 

分 类 号：R683.42[医药卫生—骨科学]