胫骨pilon骨折的治疗体会

【摘要】 目的探讨总结胫骨pilon骨折治疗方法和疗效。方法2002年1月至2008年12月,共治疗pilon骨折28例,其中男20例,女8例。年龄15-58岁,平均37.5岁;坠落伤15例,交通事故10例,运动扭伤1例,重物砸伤2例。开放性骨折8例,均行急诊手术;闭合性骨折20例,受伤至手术时间30min～15 d;平均6.1 d。按Ruedi-Allgower分型,I型4例,II型16型,III型8例。3例行牵引或石膏外固定;8例行有限切开加外固定支架;17例行切开复位支撑钢板内固定。结果术后随访2～5年5个月,平均3.8年。采用Mazur评分标准,优9例,良13例,可4例,差2例。术后合并切口皮肤表浅感染1例,1例术后切口周缘皮瓣坏死,2例继发踝关节创伤性关节炎。结论pilon骨折并发症多而且后果严重,pilon骨折的解剖复位和固定可获得最佳临床结果,以预防创伤性关节炎,关节僵直等并发症,最大限度地恢复踝关节功能。更多还原

【Abstract】 Objective Study the treatment and curative effect of tibial pilon bone fracture.Methods From January,1996 to December,2001,we totally cured 28 cases of the pilon bone fracture,among them male 20 cases,female 8 cases.Age bracket15 58 years old,37.5 years old on average;15 cases of them are due to falls,10 cases caused by traffic accident,1 by the sport sprains,and 2 by blows.There are 8 cases of open fracture,on all of which were performed an emergency operation;and 20 cases of closed fracture;The time from being hurt to operation ranges from 30 minutes to 15 days;average 6.1 days.Typed according to Ruedi All Gower,3 cases of type I,16 cases of type II,and 9 cases of type III.On 3 cases were performed fixation of gypsum or traction;8 cases were performed limited incision with external fixation support;And 17 performed incision and restoration with internal fixation of steel plate.Results We have been visiting the patients after their operations for 25 years and 5 months,3.8 years on average.According to the standard of Mazur,9 cases have excellent result,13 cases good,4 cases fair,2 cases bad.After operations,1 case with epidermis infection by the incision;and 1 with the surrounding skin valve spoiled to dead.2 cases developed into the traumatic ankle arthritis.Conclusion Pilon bone fractures complications is frequently-occurring and the consequence can be serious,the restoration and fixation through incision for the pilon bone fracture will bring the best clinical result,to prevent the complications such as the traumatic arthritis,joint stiff,and recover the ankle joint function as much as possible.更多还原