Ⅱ、Ⅲ型Pilon骨折治疗手术时机的选择  

Operation timing of type Ⅱ and type Ⅲ Pilon fractures

作　　者：史智伟[1] 周鸣[1] 刘磊[1] 

机构地区：[1]宜兴市人民医院骨科,江苏宜兴214200

出　　处：《临床骨科杂志》2012年第2期183-184,共2页Journal of Clinical Orthopaedics

摘　　要：目的探讨手术时机对切开复位内固定治疗Ⅱ、Ⅲ型Pilon骨折疗效的影响。方法对96例Ⅱ、Ⅲ型Pilon骨折患者按受伤至手术时间分为两组,早期手术组44例,于伤后12 h或3 d内行切开复位解剖钢板内固定术;延期手术组52例,于伤后7～14 d待肢体肿胀消退后手术。对两组术后进行随访分析。结果 96例均获随访,时间10～24(15.3±3.4)个月。踝关节功能优良率早期手术组为79.6%,延期手术组为84.6%,差异无统计学意义(P>0.05);延期手术组在骨折愈合时间、术后并发症发生率、术后下床活动时间及开始负重时间等指标上均优于早期手术组,差异有统计学意义(P<0.05)。结论手术时机选择是Ⅱ、Ⅲ型Pilon骨折治疗的关键,延期手术有利于提高远期临床疗效,减少并发症的发生。Objective To investigate the impact of operating timing on the treatment of type Ⅱ and type Ⅲ Pilon fractures.Methods According to operative time,96 patients were divided into two groups.In early operation group,48 patients were treated with open reduction internal fixation in 12 hours or 3 days after injury.In delayed operation group,52 patients were treated with same operation when the swell of soft tissue subsidised in 7～14 days after injury.Results All patients were followed up from 10 to 24 months with an average of（15.3±3.4） months.There was no significant difference in the good rate of ankle function evaluation between delayed operation group（84.6%） and early operation group（79.6%）（P0.05）.The time of fracture healing,incidence of complications,time to get out of bed and weight-loading time in emergency operation group were significantly better than those in early operation group（P0.05）.Conclusions The choice of operating time plays an important role in treating type Ⅱ and type Ⅲ Pilon fractures.Delayed open reduction internal fixation can contribute to improve the long-term clinical effect and reduce complications.

关 键 词：PILON骨折 切开复位内固定 延期手术 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]