文档介绍：应用有限内固定结合外固定架治疗胫骨Pilon骨折
【摘要】目的:观察有限内固定结合外固定架治疗胫骨Pilon骨折的临床效果。方法:对2002年1月~2006年12月单侧胫骨Pilon骨折患者12例采用有限切开内固定并辅以外固定架外固定,。结果:本组患者12例,优10例,良2例。术后并发症:创面不愈合2例,感染1例。结论:胫距关节面的解剖复位和恢复肢体长度是治疗本病的关键。此术式可早期活动踝关节,是治疗Pilon骨折一种较好的选择。
【关键词】 Pilon骨折;骨折固定术;外固定架
[ABSTRACT] Objective: To evaluate the clinical effects of the limited internal bining with external fixation for the treatment of Pilon fractures. Methods: Twelve patients with unilateral tibia Pilon fracture were treated with limited internal bining with external fixation, followup of an average period of months were conducted. Results: According to Mazur's criterion, es of the treatment were evaluated as excellent in 10 patients, good in 2. Complications of wound dehiscence were observed in 2 cases, infection in 1 case. Conclusion: In this procedure, restoring normal limb length and accurate anatomical reduction of tibial astragaloid joint is the key to ess. This method allows ankle joint to move early and is an optimal choice for Pilon fractures.
[KEY WORDS]Pilon fracture; Fracture fixation; External fixation
Pilon 骨折一般是指胫骨远端1/3波及胫距关节面的骨折,胫骨远端关节面严重粉碎,骨缺损及远端松质骨压缩。胫骨Pilon骨折是高能量损伤导致胫骨远端及关节面的骨折,高能量致使胫骨干骺端多呈粉碎性骨折,作为治疗上最具有挑战性的骨折之一,Pilon骨折的特征决定了临床治疗的困难性和特殊性,因其本身为胫骨干骺端的粉碎性骨折,使踝关节特别是胫骨负重面产生不同程度的碎裂,其并发症发生率很高[1]。Pilon骨折治疗的发展过程,反映了内固定材料技术发展和人们对损伤原因(能量状态)的认识过程。我院2002年1月~2006年12月施行有限内固定结合超踝关节可动外固定架手术治疗胫骨Pilon骨折患者12例,临床效果满意