联合入路治疗Pilon骨折  

Efficacy of combined approach for treatment of Pilon fractures

作　　者：郭晓鹏[1] 尚晖[1] 吴亚鹏[1] 

机构地区：[1]十堰市太和医院(湖北医药学院附属医院)骨三科,湖北十堰442000

出　　处：《临床骨科杂志》2017年第3期350-351,共2页Journal of Clinical Orthopaedics

摘　　要：目的探讨联合入路手术治疗Pilon骨折的临床疗效。方法采用联合入路治疗17例Pilon骨折患者。根据不同骨折类型选择手术入路和固定方式。应用Burwell-Charnley影像学评估标准评定骨折复位情况,按AOFAS评分评定临床疗效。结果 17例均获得随访,时间6~21个月。解剖复位13例,一般复位4例。15例切口一期愈合;1例切口皮缘少许坏死,经换药后愈合;1例钢板及螺钉外露行皮瓣覆盖创面。患者骨折均在术后16~18周愈合。末次随访时AOFAS评分标准评定临床疗效:优10例,良2例,可3例,差2例。结论联合入路手术治疗Pilon骨折,可使骨折得到满意的复位和可靠的内固定,防止复位丢失。Objective To explore the clinical efficacy of using combined approach for treatment of Plion fractures.Methods The 17 patients with Pilon fractures were included,they were treated with combined approach.According to different type fractures,they were selected the surgical approach and different methods of internal fixation.Radiographic fracture reduction assessment was used by Burwell-Charnley standard.According to the AOFAS score,clinical curative effect was evaluated.Results All 17 cases were followed up for 6~21 months.There were 13 cases of anatomical reduction,4 cases of general reduction.There were 15 cases of incision healing directly,1 case of skin incision margin appeared necrosis,and got healing after dressing;1 case of plate and screw exposed which underwent flap coverage on the wound.The fractures were healed in 16~18 weeks postoperatively.At last follow-up,reset by the AOFAS scores were excellent in 10 cases,good in 2,fair in 3,and poor in 2.Conclusions For Pilon fractures,the combined approach is an effective surgical procedure.The clinical effect is satisfactory,which avoid the loss of reduction.

关 键 词：PILON骨折 联合入路 解剖锁定钢板 

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