胫骨远端解剖锁定钢板治疗复杂Pilon骨折  

Anatomic and "L"-shaped Locking Compression Plate for Treatment of Complex Pilon Fracture

作　　者：詹玉林[1] 夏荣刚[1] 陈旸[1] 贾伟涛[1] 张长青[1] 曾炳芳[1] 

机构地区：[1]上海市第六人民医院骨科,200233

出　　处：《中国骨与关节损伤杂志》2011年第10期894-896,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨胫骨远端"L"型解剖锁定钢板治疗复杂Pilon骨折的临床疗效及手术技巧。方法对17例复杂Pilon骨折行骨折切开复位、胫骨远端"L"型解剖锁定钢板内固定、植骨术。结果术后15例切口一期愈合,2例出现2 mm的切口边缘坏死,经换药后愈合。本组随访8～18个月,平均15.5个月。骨折愈合时间14～20周,平均16.3周。根据AOFAS评分系统进行评定:优12例,良4例,可1例,优良率为94.1%。结论胫骨远端"L"型解剖锁定钢板治疗复杂Pilon骨折疗效满意,但术前需要仔细判断病情并精心准备手术方案。高质量的X线片及骨折部位的CT三维重建对手术方案的制定有指导意义,术中需要采取正确的骨折固定顺序,围手术期应给予减轻水肿的处理。Objective To explore the clinical effectiveness and skitls of using the anatomic and ＂L＂-shaped locking compression plate （LCP） to treat the complex P/Ion fracture. Methods A total of 17 patients with P/ion fractures were treated with open reduction and fitxation with the minimally invasive techniques, and internal fixation with the ＂L＂-shaped locking compression plate（LCP） and bone graft. Resuits Fifteen cases＇ incision healed by first intention, the edge of incision necrosis oceured in 2 cases, but healed after dressing change. The average follow-up period was 15.5 months （8-18 months）. The average time of healing fracture was 16.3 weeks （14-20 weeks）. According to American Orthopedics Food Ankle Society scale, the results were evaluated as excellent in 12 cases, good in 4 cases, fair in 1 case. The rate of excellent and good was 94.1%. Conclusion The treatment of P/ion fracture with anatomic ＂L＂-shaped locking compression plate is effective. During the operation, the key step is to restore the shape of the ankle joint and the length of the lower normal gravity line.

关 键 词：PILON骨折 锁定钢板 手术治疗 

分 类 号：R683.42[医药卫生—骨科学]