分步延期手术治疗高能量Pilon骨折临床的研究.doc

Urgery High-energy Pilon FractureClinical Research Speciality: Orthopaedics of TCM Author: Wang Yunlong Tutor: Prof. Zhang Junzhong Abstract Objective: to study the delay surgery by high-energy Pilon fracture of the feasibility and clinical effect. Methods: retrospective analysis method, in our hospital in March 2009 to August 2011 have follow-up record of 46 patients with high energy Pilon fracture patients, according to the injury to surgery after the time and treatment measures are divided into different step likely delay (hereinafter referred to as the group A) and early internal fixation (orif group (hereinafter referred to as the group B), among them, A group of 26 patients first first step after admission, namely mat high limb parallel traction with bone, then pulling status active functional exercise descending, and use mannitol, beta seven YeZao glucoside sodium promote swelling, wait for local blisters healed or swelling basic receded followed the second step, namely the surgery, and the B group of 20 cases, 8 hours after injury emergency go to surgery. Patients were followed up for 10 ~ 24 months, mean 16 months. To compare the two groups of patients, operation time, peri-operative bleeding, fracture restoration, postoperative complications, the soft tissue fracture healing time and postoperative function recovery ankle and statistical analysis. Results: in the fracture restoration, the healing time, no difference between the two groups; A group of operation time, peri-operative bleeding and postoperative complications of soft tissue was significantly lower than the B group; Group A function recovery ankle was good in group B. Conclusion: the correct choice of open reduction and internal fixation operation time, the treatment of fractures of high-energy Pilon is critical, the operation time to choose the correct, can effectively decrease complications, the early even in 8 hours emergency within go to surgery, there are still very high risk, and use step-