分段延期治疗高能量损伤Pilon骨折26例分析  

CLINICAL EFFECT OF THE STAGED DELAYED THERAPY OF SEVERE PILON FRACTURE

作　　者：张爽[1] 李鹏飞[1] 李晋[1] 任长乐[1] 李庆[1] 崔文权[1] 毕伟[1] 齐志明[1] 

机构地区：[1]辽宁省大连市中心医院骨科,116000

出　　处：《中国煤炭工业医学杂志》2012年第2期179-181,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的总结对高能量损伤的Ruedi Allgower分型Ⅱ型、Ⅲ型Pilon骨折分段延期治疗的疗效。方法 2008年1月—2010年10月我院收治的26例Ⅱ、Ⅲ型高能量胫骨Pilon骨折患者,男21例,女5例,年龄18～65岁,平均41岁。致伤因素:高处坠落伤20例,交通事故伤5例。Ruedi Allgower分型:Ⅱ型7例,Ⅲ型19例,随访结果按照踝关节Mazur评分标准进行综合评价,均一期在伤后8h内行腓骨切开复位内固定,胫骨手法复位、外固定架外固定,术后脱水、消肿、预防感染治疗,伤后7～14d左右待软组织条件恢复后二期行有限切开复位LCP内固定,髂骨植骨术。结果无骨折不愈合和感染及皮肤坏死患者,术后按照Mazur等制定评分系统从踝关节的症状及功能上进行评价。其中优18例,良4例,可3例,差1例。结论对高能量损伤的Ruedi Allgower分型Ⅱ型、Ⅲ型Pilon骨折分段延期治疗可以有效的减少并发症的发生。Objective To discuss the efficacy of staged management of Ruedi Allgower typeⅡ and type Ⅲpilon fractures. Methods From January 2008 to October 2010, 26 patients with type Ⅱ and type Ⅲ pilon fractures were treated. 21 Males and 5 females,aged from 18 to 65 years with an average of 41 years. Injury mechanism： high falling for 20 and traffic accident for 5. Classification by Ruedi Allgower .. type Ⅱ for 7 and type Ⅲ for 19 . The efficacy of followed up was assessed with Mazur scores for ankle joint. All had an open reduction internal fixation for the fibular fracture and closed reduction external fixation for the tibial fractures within 8 hours after injury with related management for the soft tissue. When the soft tissue was stable a limited open reduction internal fixation with LCP and ilia transplantagtion for tihial fracture were performed as a definite fixation. Results No case with nonunion or infection or skin necrosis was ob- served. By the Mazur scores for ankle joint, excellent was for 18 ,good for 4 ,fair for 3 and poor for 1. Conclusion staged management of Ruedi Allgower type Ⅱ and type Ⅲsevere pilon fractures can reduce the incidence of relative complications.

关 键 词：PILON骨折 外固定架 有限切开复位 分段延期 高能量损伤 

分 类 号：R683.42[医药卫生—骨科学]