解剖型锁定钢板治疗Pilon骨折的临床疗效分析  

Analysis of the Clinical Efficacy of Anatomic Locking Plate in the Treatment of Pilon Fractures

作　　者：孙克理 袁志[1] 毕龙[1] 王连军[1] 王怀斌[1] 

机构地区：[1]第四军医大学西京骨科医院,陕西西安710032

出　　处：《现代生物医学进展》2014年第31期6090-6092,6121,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30901532)

摘　　要：目的：探讨解剖型锁定钢板治疗Pilon骨折的临床疗效和安全性。方法：选择2009年1月～2012年12月采用解剖型锁定钢板内固定治疗30例Pilon骨折患者为研究对象，所有患者在无明显手术禁忌情况下，均行开放复位钢板内固定术。术后采用Mazur评分系统评价手术效果。结果：本组全部患者均获得随访，骨折平均愈合时间为4．1个月；参照Mazur踝关节功能评分系统：优14例，良13例，可2例，差1例，优良率90％。仅1例开放性Pilon骨折患者发生皮肤感染坏死，局部缺损，经清创、VSD覆盖负压吸引，待新鲜肉芽组织形成后，行带蒂皮瓣移植术，愈合良好。结论：解剖型锁定钢板的解剖形态好，成角稳定，用于治疗Pilon骨折能够恢复关节面的完整性、稳定性，减少并发症的发生，临床效果好，安全性高。Objective： To investigate the clinic efficacy and security of anatomic locking plate in the treatment of Pilon fractures. Methods： This retrospective study related to 30 patients with Pilon fractures treated by anatomic locking plate from January 2009 to December 2012. According to Ruedi-Allgower classification, there were 10 cases of type I , 8 cases of type Ⅱ, and 12 cases of type Ⅲ. All the patients were treated by using open reduction and plate fixation after contraindication was excluded. Mazur ankle scoring system was used to evaluate the postoperative surgical effect. Results： All patients were followed up, with a mean bone healing time of 4.1 months.According to the Mazur score system for ankle function, 14 patients were excellent, 13 patients were good, 2 patients were moderate and 1 patient was bad. The excellent and good rate was 90%. Skin necrosis infection and local defects were found in only 1 case of open Pilon fractures, which were treated by means of debridement, and covering VSD and healed well after the fresh granulation tissue formed, pedicle skin flap transplantation. Conclusion： The anatomic locking plate could be applied to treat Pilon fractures, with the advantage of good anatomical form and angle stability, which could restore the integrity and stability of ankle joint, reduce the complications, and achieve good clinical effects and high safety.

关 键 词：Plion骨折 解剖型锁定钢板 切开复位内固定 临床疗效 

分 类 号：R683.42[医药卫生—骨科学]