【摘要】 目的回顾性分析治疗P ilon骨折的适宜手术方法、最佳手术时机及其手术疗效。方法对2001年至2004年接受手术治疗的52例单侧P ilon骨折患者进行随访,平均年龄36.5岁,伤后至手术时间平均6.8 d。骨折类型:Ⅰ型4例、Ⅱ型36例、Ⅲ型12例。40例行切开复位三叶型(或T型)钢板内固定;12例行有限切开内固定并辅以外固定,其中应用外固定支架者2例,辅以石膏托者10例。术后平均随访16个月。结果采用Mazur评分系统评估手术疗效,52例患者中,优43例,良6例,可3例。术后并发症包括创面不愈合4例,感染2例,延迟愈合1例和关节退行性变7例。结论正确选择手术时机,根据骨折类型和条件灵活选择固定方式是取得良好手术效果的关键。更多还原

【Abstract】 Objective To evaluate the choice of operative method,timing of surgery and the outcome of tibial Pilon fracture.Methods fifty-two patients with unilateral tibial Pilon fracture operatively treated between 2001 to 2004 were followed up.The average age was 36.5 years(ranged from 19 to 57 years).The average period between injury and surgery was 6.8 days.According to the Ruedi-Allgower classification there were 4 cases of type I fracture,36 cases of type Ⅱ fracture and 12 cass of type Ⅲ fracture.During operation,40 patients had the fractures reduced,and internal fixation was done with the clover leaf plate(or with the T type plate).12 patients had limited open reduction and internal fixation coupled with external fixation,which include 2 patients with the external fixation apparatus and 10 patients with plaster splint.The average follow-up period of 52 patients was 16 months.Results According to Mazur’s criterion,the results of the treatment was evaluated as excellent in 43 patients,good in 6 patients and fair in 3 patients.Complications included wound dehiscence in 4 cases,infection in 2 cases,delayed union of fracture in l cases and late degenerative change of the ankle joint in 7 cases. Conclusions It is important to have the right choice in timing of surgery and correct method of fixation in tibial Pilon fractures for a satisfactory result.更多还原