摘要
目的评估分阶段延期切开复位内固定治疗严重pilon骨折的临床疗效。方法2003年12月至2008年2月收治23例高能量损伤pilon骨折患者,根据Rtiedi—AllgSwer分型:Ⅱ型9例,Ⅲ型14例。所有患者急诊行腓骨切开复位内固定,内侧超踝关节支架临时外固定。7~10d(平均8d)后拆除外固定支架,行胫骨远端骨折切开复位内固定。结果所有患者均获得随访,时间13~34个月,平均25个月。骨折愈合时间8~30周,平均18周,按照Teeny和Wiss等踝关节功能评分系统评分:优13例,良7例,可2例,差1例,优良率为86.9%。2例术后出现局部软组织并发症,包括1例皮肤坏死,1例切口浅表感染,通过换药后治愈。结论分阶段治疗严重pilon骨折能有效降低软组织并发症,提高关节面的复位质量。
Objective To evaluate the two-staged treatment of types Ⅱ and Ⅲ pilon fractures. Methods From December 2003 to February 2008, 23 severe cases of pilon fractures underwent emergent fibular fixation and medial spanning external fixation. According to the Rtiedi-Allgower classification, there were 9 cases of type Ⅱ, and 14 type Ⅲ. After the external fixation for 7 to 10 days (average, 8 days), the fixators were removed and the patients underwent open reduction and internal plating. Results All patients were available for an average follow-up of 25 months (range, 13 to 34) after surgery. All fractures healed at an average of 18 weeks (range, 8 to 30) postoperatively. There were 13 excellent cases, 7 good, 2 fair, and 1 poor according to the ankle scoring of Teen and Wiss. The complications included skin necrosis in 1 case and wound superficial infection in 1 case, which were successfully treated by local changes of dressing. Conclusion The two-stage treatment protocol for severe pilon fractures can decrease soft tissue complications and improve articular anatomical reconstruction.
出处
《中华创伤骨科杂志》
CAS
CSCD
2009年第11期1039-1041,共3页
Chinese Journal of Orthopaedic Trauma
关键词
胫骨骨折
骨折固定术
Tibial fracture
Fracture fixation