胫骨前外侧锁定钢板治疗Pilon骨折疗效分析  

Clinical analysis of treatment in tibial Pilon fracture with tibial anterolateral locking compression plate

作　　者：邹华章[1] 佟方明[2] 付建华[2] 柳昱[2] 陆锐均[2] 黄有志[2] 

机构地区：[1]广州医学院第四附属医院骨科,广州5114471 [2]广州医学院第五附属医院骨科,广州510700

出　　处：《岭南现代临床外科》2013年第1期65-68,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨胫骨前外侧锁定钢板治疗胫骨Pilon骨折的疗效。方法选择2006年1月～2011年5月收治的31例胫骨Pilon骨折的临床资料,包括男28例,女3例;平均年龄38.9岁。Ruedi-Allgower骨折分型:Ⅰ型2例,Ⅱ型23例,Ⅲ型6例。根据Tscheme-Gotzen软组织损伤分度:闭合性损伤0度2例,1度16例,2度6例,3度1例;开放性损伤1度4例,2度2例。31例Pilon骨折全部采用胫骨前外侧锁定钢板切开复位内固定治疗。结果 31例均获随访(12～36月,平均20月)。骨愈合时间10～24周,平均14周。Teeny和Wiss术后影像学复位评估,关节面解剖复位率为80.6%;Mazur术后功能评分系统评估,优16例,良10例,可4例,差1例,优良率为83.8%。结论采用胫骨前外侧锁定钢板治疗Pilon复位理想、固定牢靠,有利于早期功能锻炼。Objective To discuss the curative effects on treating the tibial Pilon fracture with tibial anterolateral locking compression plate （LCP）. Methods Thirty-one tibial Pilon fracture were treated from January 2006 to May 2011, including 28 males and 3 females aging from 18 to 65 （average 38.9）. According to Ruedi Allgower classification system of Pilon fracture, type I had in two cases, type 11 in 23 and type m in 6. According to Tscheme-Gotzen graduation system of soft tissue injury, 25 cases were closed fracture, 2 cases were in grade 0, 16 cases in grade 1, 6 cases in 2, 1 case in 3, and 6 cases were open fracture, which were 4 cases in grade l, 2 cases in 2. All patients were treated with LCP. Results The patients were followed up for 12 to 36 months （average 20）. All fractures were healed at an average of 14 weeks ranging from 10 to 24 weeks. According to Tenny＇s and wiss radiological evaluation system, 80.6% of fractures were achieved to anatomical reduction. There were 16 cases excellent, 10 good, 4 fair, and one poor, with a good-to-excellent rate of 83.8% according to the Mazur＇s criteria. Conclusion Tibial anterolateral LCP can obtain desired reduction, firm fixation for treating Pilon fracture and is helpful for early functional exercise of joint and reduce complications.

关 键 词：胫骨骨折 PILON骨折 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学]