摘要
目的 回顾性分析了治疗 Pilon骨折的适宜手术方法、最佳手术时机及其手术疗效。方法 对 1997年至2 0 0 2年接受手术治疗的 5 2例单侧 Pilon骨折患者进行随访 ,平均年龄 37.8岁 ,伤后至手术时间平均 6 .8d。骨折类型 : 型 4例、 型 36例、 型 12例。 4 0例行切开复位三叶型 (或 T型 )钢板内固定 ;12例行有限切开内固定并辅以外固定 ,其中应用外固定支架者 2例 ,辅以石膏托者 10例。术后平均随访 2 8.4个月。结果 采用 Mazur评分系统评估手术疗效 ,5 2例患者 ,优 4 3例 ,良 6例 ,可 3例。术后并发症包括创面不愈合 4例 ,感染 2例 ,延迟愈合 1例和关节退行性变 7例。结论 正确选择手术时机 。
Objective To evaluate the choice of operative method,timing of surgery and the outcome of tibia pilon fracture.Methods fifty-two patients with unilateral tibia pilon fracture operatively treated between 1997 to 2002 were followed up.The average age was 37.8 years(rang from 18 to 56 years).The average period between injury and surgery was 6.8 days.According to the Redi-Allgwer classification,there were 4 cases of type Ⅰ fracture,36 cases type Ⅱ fracture and 12 cases type Ⅲ fracture.During operation,40 patients had the fractures reduced and internal fixation was done with the cloverleaf plate (or with the T type plate).12 patients had limited open reduction and internal fixation coupled with internal fixation,which include 2 patients with the external fixation apparatus and 10 patients with plaster splint.The average period of follow-up apparatus and 10 patients with plaster splint.The average period of follow-up of these 52 patients was 28.4 months.Results According to Mazur′s criterion,the result of the treatment was evaluated as excellent in 43 patients,good in 6 patients and fair in 3 patients.No poor result was found complications included wound dehiscence in 4 cases,infection in 2 cases,delayed union of fracture 1 case and late degenerative change of the ankle joint in 7 cases.Conclusion It is important to have the right choice in timing of surgery and correct method of fixation in tibia pilon fractures for a satisfactory result.
出处
《实用骨科杂志》
2005年第1期32-34,共3页
Journal of Practical Orthopaedics
