【摘要】 目的探讨复杂Pilon骨折延期切开有限内固定结合石膏外固定治疗的临床疗效。方法对26例复杂Pilon骨折(Ruedi-AllgowerⅢ型)均行延期切开有限内固定结合石膏外固定治疗。结果术后发生切口感染4例,3例经植皮治愈,1例经反复换药2.5个月,3个月后取出内固定物后愈合。骨折延迟愈合2例,均为大块髂骨植骨,髂骨面重建踝关节面患者,术后1.5年骨折愈合。26例均获随访,平均31(22~56)个月,按Mazur评分法评定疗效:优10例,良12例,可4例,优良率为84.6%(22/26)。结论根据骨折类型和软组织条件,采用延期有限切开内固定结合石膏外固定治疗复杂Pilon骨折能有效减少局部并发症,并获得较好的踝关节功能。更多还原

【Abstract】 Objective To research the clinical effect of limited open reduction and internal fixation combined with plasterboard external fixation for complicated pilon fracture.Method All 26 pilon fracture patients with Ruedi-Allgower type Ⅲ were treated by limited open reduction and internal fixation combined with plasterboard external fixation.Results Four cases were found incision infection.Among them,3 cases were cured by skingrafting,and one case by change dressings for 2.5 months and internal fixator removal 3 months after the operation.Two cases who received mass iliac bone graft and facies articularis malleoli reconstruction by articular surface of ilium emerged delay union,and then healed 1.5 years after the operation.Conclusions Limited open reduction and internal fixation combined with plasterboard external fixation is an ideal therapy for complex pilon fracture with the suitable fracture type and soft tissue.It can reduce the complications and nonunion availably,and obtained a satisfactory result with well restoring of anatomical articular surface,joint space and joint function.更多还原