动力型外固定架结合有限内固定治疗Pilon骨折_临床医学论文.docVIP

动力型外固定架结合有限内固定治疗Pilon骨折_临床医学论文 动力型外固定架结合有限内固定治疗Pilon骨折_临床医学论文 【摘要】 目的 探讨Orthofix动力型外固定支架结合有限内固定在治疗高能量Pilon骨折中的价值。方法 2002年4月至2004年3月对11 例高能量Pilon骨折采用Orthofix公司第四代跨关节外固定结合克氏针或螺钉有限内固定治疗，远端外固定螺钉固定于跟骨和距骨颈，外固定活动轴和踝关节运动的轴心位置保持一致。术后3周开始踝关节功能锻炼，2～5个月后去除外固定。结果 11 例均得到随访，随访6～18个月(平均13个月)，骨折全部达骨性愈合，无切口感染、内植物外露等并发症。踝关节症状与功能评分按Mazur标准进行，临床评分68～97分(平均82分)，其中优6 例，良4 例，可1 例。结论 Orthofix跨关节动力型外固定支架结合有限内固定治疗高能量Pilon骨折能促进骨折愈合，有利于踝关节早期活动，最大程度恢复踝关节功能，是治疗高能量Pilon骨折的一种理想方法。 【关键词】 Pilon骨折 踝关节 外固定 有限内固定 Dynamic External Fixator Combined with Limited Internal Fixation for the Treatment of High Energy Pilon Fractures Abstrac：Objective To investigate the value of Orthofix dynamic external fixator combined with limited internal fixation for the treatment of high energy Pilon fractures.Methods From April 2002 to March 2004，11 patients with high energy Pilon fractures were treated with Orthofix dynamic external fixator combined with limited open reduction and internal fixation with screws and Kirschner wires，with two distal external pins inserted into talus and calcaneus respectively so that the rotation axis of external fixator was coincided with that of ankle joint.After approximately postoperative two weeks，the articular hinge was released and the patient began ankle exercises.External fixators were removed at postoperative 2～5 months.Results 11 patients were followed up.The average period of following up was 13 months(range 6 to 18 months).There was no nonunion occurred.According to Mazur ankle joint scoring system，the symptom and function evaluation of the ankle was scored from 68 to 97(average 82).Clinical results demonstrated 6 excellent，4 good，1 fair.Conclusion Orthofix dynamic external fixator combined with limited internal fixation is satisfying technique to treat high energy Pilon fractures.This technique can effectively decrease both wound and bone healing complications and enable early ankle joint to move，restore largly function of ankle joint. Key words：pilon fracture；ankle joint；