分期手术治疗Pilon骨折的临床研究  

Clinical research of stage surgical treatment of Pilon fractures

作　　者：李彬[1] 李宣隆 汪永泉[1] 陈茂辉 谢小庆[1] 陈巍[1] 

机构地区：[1]泸州市中医医院骨科,四川泸州646000

出　　处：《西部医学》2011年第8期1440-1441,1443,共3页Medical Journal of West China

基　　金：泸州市卫生局资助课题(No:2009-55)

摘　　要：目的探讨分期手术治疗胫骨Pilon骨折的方法及意义。方法对39例Pilon骨折患者进行手术治疗,根据Ruedi和Allgower分型[1]:Ⅰ型6例,Ⅱ型19例,Ⅲ型14例;按Tscheme-Gotzen开放性损伤分度:0度13例,1度7例,2度12例,3度7例;Tscheme-Gotzen 0度的13例采用延期手术;Tscheme-Gotzen 1～3度采用一期切开复位腓骨有限内固定,Tscheme-Gotzen 2～3度的19例患者采用腓骨有限内固定加持续负压封闭引流技术。结果本组患者均获随访,随访时间12～36个月,平均26个月。骨折愈合时间平均14周。优21例,良11例,差7例,优良率为82.05%。结论胫骨Pilon骨折手术治疗可实行个体化分期治疗,尤其是在开放性骨折的患者中,早期对腓骨进行可靠的内固定是一种比较理想的方法。Objective To evaluate the surgical treatment of stage Pilon fractures.Methods There were is 6 cases withⅠ type,19 cases with Ⅱ type and 14 cases with Ⅲ type of 39 patients with Pilon fractures,according to Ruedi and Allgower classification.There were 13 cases with 0 degrees,7 cases with one degree,12 cases with 2 degrees and 7 cases with 3 degrees according to Tscheme-Gotzen.13 cases with 0 degree were treated with delayed operation.The patients with 1-3 degrees were treated with limited open reduction and internal fixation of fibula.The patients with were treated with limited internal fixation of fibula sustained vacuum sealing drainage.Results The patients were followed up for an average of 26 months（ranging from 12 to 36 months）.The average healing time was 14 weeks（12-24 weeks）.The good rate is 82.05%.Conclusion Surgical treatment of tibial Pilon fractures of the implementation of individual stages can be treated,especially in patients with open fractures.A reliable fixation of fibula early is an ideal approach.

关 键 词：PILON骨折 有限内固定 分期治疗 

分 类 号：R681.8[医药卫生—骨科学]