Pilon骨折诊断及治疗.docVIP

Pilon骨折诊断及治疗 　 作者：尚永军，廖宏喜，刘强，杨凤东，王江波，王威，任胜军 【摘要】 目的 探讨Pilon骨折的诊断与治疗方法。方法 对我院2002年5月至2006年5月收治的20 例Pilon骨折，根据骨折类型，分别采用不同手术方法治疗。结果 20 例患者均获得随访，随访时间1～3年，平均2年1个月。20 例患者中13 例行切开复位钢板内固定术，5 例行外固定架固定术，2 例行踝关节融合术，根据AOFAS踝关节功能评定标准评分，优16 例，良2 例，可2 例，优良率90％。Ⅰ型6 例评分(92±2.6)分；Ⅱ型10 例，9 例评分(93±1.7)分，1 例评分(70±2.6)分；Ⅲ型4 例，3 例评分(90±2.1)分，1 例评分(70±2.0)分。结论 Pilon骨折需早期及正确诊断，根据骨折类型、损伤程度及时有效地采取恰当的手术治疗，可以获得关节解剖复位，恢复下肢力学轴线，保持关节稳定，达到骨折愈合和重获一个有功能、无疼痛、能负重、可运动的关节，避免感染和创伤并发症的发生。 【关键词】 Pilon骨折；钢板内固定；外固定架固定；踝关节融合 Diagnosis and Treatment of Pilon Fracture Abstract：Objective To study the diagnosis and treatment of Pilon fracture.Methods 20 patients of Pilon fracture according to its types were treated with different operation ways from May 2002 to May 2006 in our hospital.Results The following up period was 1～3 years，an average of 25 months.All of the patients got it.13 patients among the 20 ones were opened reduction and put some internal fixation of plate into it to make it recover normally.5 cases were performed with external fixation in fixed frame，2 cases were performed with ankle fusion.16 casesankle recovery were performed excellently，2 cases well and 1 case ordinarily while the excellent and good rate was 95％ according to AOFAS standard，The first type includes 6 cases，the score (92±2.6).The second type includes 10 cases，9 cases′ score (93±1.7)，one case′s score (75±2.6).The third one includes 4 cases，3 cases′ score (90±2.1)，one case′s score (75±2.0).Conclusion Pilon fracture need be diagnosed early and correctly.According to fracture types and levels we should do proper operation effectively in time.We could restore the joint，mechanics axis while remain the joints stability and make the joint healed and regain a joint which is functional，no pain moveable，bearing proper weight.The joint can prevent infection and complications. Key words：Pilon fracture；internal fixation of plate；external fixation in fixed frame；ankle fusion Pilon骨折是由于跌落时高强度垂直负荷，运动损伤或机动车肇事引起的累及踝关节的胫骨远端骨折［1］。我院自2003年5月至2006