多切口多枚小钢板治疗Rüedi-Allg（o）werⅡ～Ⅲ型pilon骨折  

Multi-incision with multiple low-profile plates for fixation of Rüedi-Allg（o）wer type Ⅱ and Ⅲ pilon fracture

作　　者：唐三元[1] 杨辉[1] 李远辉[1] 孙鸿涛[2] 詹鹏[1] 唐天华[1] 

机构地区：[1]暨南大学附属珠海医院创伤骨科,珠海519000 [2]广东省第二人民医院骨科

出　　处：《中华创伤杂志》2014年第7期684-687,共4页Chinese Journal of Trauma

摘　　要：目的 探讨多切口多枚小钢板（multiple low-profile plate,MLPP）内固定治疗Rüedi-Allg（o）werⅡ～Ⅲ型pilon骨折的疗效. 方法 回顾性分析2007年7月-2012年3月采用多切口MLPP固定治疗且获得随访的21例pilon骨折患者资料.其中Rüedi-Allg（o）werⅡ型7例,Ⅲ型14例.根据X线片及CT显示的骨折折线累及范围选择多个切口,采用MLPP固定骨折.采用Burwell-Charnley影像学评价标准评价复位质量,美国足踝外科协会（American Orthopedic Foot＆Ankle Society,AOFAS）踝与后足功能评分评价踝关节及后足功能.统计骨折类型、骨折愈合率、切口并发症发生率. 结果 骨折均愈合,骨折复位优良率为95％（20/21）;AOFAS评分优11例,良6例,可4例,优良率达81％.无切口感染患者,1例切口开裂,5例发生创伤性关节炎. 结论 多切口MLPP固定治疗pilon骨折可减少切口并发症,有利于骨折复位、稳定,以达到早活动、晚负重的要求.Objective To assess the outcome of fixation of Rüedi-Allg（o）wer type Ⅱ and Ⅲ pilon fracture using multiple low-profile plates （MLPP） via multiple incisions.Methods A retrospective study was made on 21 cases of pilon fracture immobilized using MLPP via multiple incisions between July 2007 and March 2012.There were 7 cases of Rüedi-Allgower type Ⅱ and 14 type Ⅲ.Fractures were reduced and fixed based on X-ray films and CT scans for fracture line and effect area.Quality of reduction was evaluated by Burwell-Charnley radiological score.Ankle and hindfoot functions were evaluated by American Orthopedic Foot ＆ Ankle Society ankle-hindfoot scale.Fracture types,healing rate,and wound complication incidence were recorded.Results All fractures were healed,with the excellence rate of 95％ （20/21）.According to AOFAS score,the results were rated as excellent in 11 cases,good in 6,fair in 4,with the excellence rate of 81％.None suffered from wound infection,except for wound dehiscence in 1 case and traumatic arthritis in 5.Conclusion Treatment of pilon fractures by MLPP via multiple incisions can reduce wound complications,promote reduction and stabilization of fracture,and satisfy the demand of early movement and late weight bearing of the ankle.

关 键 词：胫骨骨折 骨折固定术 内 切口 

分 类 号：R687.3[医药卫生—骨科学]