内外固定治疗RuediⅢ型Pilon骨折  

Internal and external fixation treat ruedi Ⅲ type of pilon fracture

作　　者：和利[1] 梁彦[2] 李卫哲[2] 贾健[2] 

机构地区：[1]天津宁河县医院,天津宁河301500 [2]天津医院创伤骨科,天津300211

出　　处：《中国现代医学杂志》2012年第35期94-97,共4页China Journal of Modern Medicine

摘　　要：目的探讨使用内固定联合外固定支架治疗RuediⅢ型Pilon骨折的临床疗效。方法 2007年7月～2011年6月采用内外固定治疗RuediⅢ型Pilon骨折27例,男14例,女13例,年龄19～48岁,平均32.6岁。致伤原因以高空坠落伤及车祸伤为主。所有患者均给予内外固定。手术采用踝正中切口,暴露胫骨远端关节面,根据骨折情况选择内固定,复位关节面,外固定支架的近侧螺钉置于胫骨骨折近端,远侧螺钉置于跟骨上。术后关节进行功能锻炼,待骨折愈合后拆除外固定支架。结果所有病例均获随访,随访时间为3～47个月,平均23个月。临床疗效满意,无切口及深部感染,无神经、血管损伤等并发症,踝关节活动良好。临床疗效根据美国足外科协会所制定的AOFAS踝-后足功能评分系统(总分100分)评价术后踝关节功能,优20例,良5例,可1例,差1例。结论内固定联合外固定支架治疗RuediⅢ型Pilon骨折固定牢靠,能减轻局部软组织的压力,减少骨折不愈合率,并且能更好地恢复关节面的解剖关系,有利于踝关节早期活动,防止关节僵硬,是一种有效的治疗方法。[Objective ] To explore the clinical effects of treatinng ruedi m type of pilon fracture by us- ing internal and external fixation. [Methods] From July 2007 to July 2011, 27 patients who suffered from ruedi m type of pilon fracture were treated with internal and external fixation. 14 cases are men, 13 cases are women. Their age are 19-48, 32.6 in average. They were mainly caused by high altitude dropping and traffic accident. All cases are operated with internal and external fixation. The surgery adopt median incision of ankle,expose distal articulation surface of tibia,and restore articulation surface by internal fixation. The proximal of external fixation placed in the proximal of tibia fracture, the distal placed in ealcaneus. After op- eration,the ankle conduct functional training. The external fixation can be removed until the fracture union. [Results] All patients are followed 3-47 months, 23 months in average. The clinical effect is satisfied, no infections of wound and no deep infection,no nerve and vessel injury,the active of ankle is good. We use AOFAS established by The United States foot surgical association to evaluate the function of ankle, 20 cases excellent, 5 cases good, lcase common, 1 case poor. [Conclusion] Internal and external fixation cure ruedi Ⅲ type of pilon fracture can lighten the pressure of soft tissue, fix firmly, less injury, reduce the rate of nonunion, and restore articulation surface, in favor of exercising ankle earlier, avoiding articulation rigid. It is a good therapy.

关 键 词：PILON骨折 外固定支架 切开复位 

分 类 号：R683[医药卫生—骨科学]