有限内固定结合外固定治疗高能量Pilon骨折的临床观察.docVIP

有限内固定结合外固定治疗高能量Pilon骨折的临床观察 徐州市第一人民医院江苏徐州221002 目的探讨有限切开复位内固定结合外固定手术方式治疗高能量Pilon 骨折的疗效。方法选取我院收治的76例高能量Pilon骨折患者的临床资料，均 接受有限切开复位内固定结合关节外固定手术方式，观察骨折愈合时间，术后并 发症，随访12个月，记录骨折愈合及功能恢复情况。结果76例骨折愈合时间 平均(21.35plusmn;1.96)周。2例发牛伤口感染，2例发牛皮肤坏死，3例踝 关节出现不同程度的功能障碍，均治疗后好转，未见骨折不愈合。术后按照Mazur JM评分系统进行评估，结果为优者33例，良者35例，优良率为89.5%o结论 有限切开复位内固定结合外固定手术方式治疗高能量Pilon骨折临床效果满意。 【关键词】高能量Pilon骨折；外固定；内固定；复位；效果 [Abstracts]objective To study the curative effect of limited in ter nal fixati on combi ned with external fixation surgery treatment on the High-energy Pilon fractures.Methods The clinical data of 21 cases of High-energy Pilon fractures were retrospectively analyzed who all receive the fixation combined with external fixation surgery treatment.The fraction healing time and its complications were observed when and after the operation.AII patie nts were received follow-up for 12 mon ths after surgery, Fracture healing and recovery were observed during the follow up after operati on .Results The average fracture heali ng time was (21.35plusm n;1.96) weeks.After the surgery, wound inf ection was happe ned in 2 cases, cuta neous necrosis was in 2 cases, The obstacle of ankle function of different level in 3 cases.But the symptoms were all improved after suitable treatment.No fracture healing were happened.According to Mazurrsquo;s criteria, the result was evaluated as exellent in 33 cases, good in 35 cases.The fine rate was 89.5%. Con elusion Limited internal fixati on combi ned with external fixation were many advantages for this kind of surgery, All of this can promote the fraction recovery and have a good clinical effect. [Key words]high-energy Pilon fracture； external fixation； internal fixation； effect 高能量Pilon骨折为暴力引起的骨折，常发生于高处坠落或车祸等高能 量情形，具有干飾端不同程度的压缩、粉碎性骨折、高度的不稳定、关节软骨的 原发损伤等特征，软组织损伤严重。本研究选取我院于2011年6月至2014年6 月收治的76例高能量Pilon骨折患者的临床资料，均采取有限切开复位内固定与 关节外固定联合治疗，分析治疗效果，总结如下。 1资料与方法 1.1临床资料 选取我院于2011年6月至2014年6月收治的76例高能 量Pilon骨折患者的临床资料，男42例，女34例，年龄18?65岁，平均年龄 (40.1plusmn;6.2)岁。受伤后20天内均接受治疗，平均时间(5.6p