摘要
目的探讨前外侧有限切开结合内侧微创锁定板接骨术治疗Pilon骨折的手术技巧及临床疗效。方法2007年3月至2012年9月采用前外侧有限切开复位结合内侧经皮微创锁定板接骨术治疗合并腓骨远端骨折的胫骨Pilon骨折26例。其中男16例,女10例;年龄23~58岁;平均37.2岁;左侧15例,右侧11例。伤后至手术时间5 h^14 d,平均8 d。所有病例均为闭合性骨折。骨折按AO/OTA分型,43C1型9例,43C2型17例。软组织损伤按Tscherne分度,0度4例,1度14例,2度8例。结果患者随访12~24个月,平均17.5个月。切口愈合良好。骨折愈合时间12~20周,平均14.2周。按Mazur踝关节评分系统评价疗效,优12例,良10例,可4例,优良率为84.1%。结论前外侧有限切开复位结合内侧经皮微创锁定板接骨术治疗Pilon骨折具有减少术中软组织损伤,保护骨折端血供,有效进行骨折复位固定的优点,术后并发症少,疗效优良。
Objective To discuss operative technique and clinical result of Anterolateral limited open reduction combined with minimally invasive medial percutaneous locking Plate osteosynthesis for the treatment of Pilon fracture. Methods 26 cases tibial Pilon fractures concommitant with distal fibular fractures were operated upon with Anterolateral limited open reduction combined with minimally invasive percutaneous plate osteosynthesis （MIPPO） using medial tibial locking compression plate fiom march 2 0 0 7 to september 2 0 1 2 , including 1 6 males and 1 0 females. Their ages were 2 3 to 5 8 years with an average of 37.2 years. The time until surgery was 5 hours to 14 days with an average of 8 days. All the cases were unilateral closed fractures including 15 left and 11 right sides. The fractures were evaluated by AO/OTA classification ,9 cases were type 43C1 and 17cases were type 43 C2. Soft tissue injury was evaluated by Tsherne classification,4 cases were grade 0,14 cases were grade 1 and 8cases cases were grade 2. Results All the incisions healed well. All patients were followed up for 12 to 24 months, and mean follow-up time was 17.5 months. The time to fractures healing was 12 to 20 weeks with an average of 14.2weeks. Accord- ing to Mazur criterion,ankle function was excellent in 12 cases, good in 10 cases, fair in 4 cases, and the excellent and good rate was 84.1%. Conclusion Anterolateral limited open reduction combined with minimally invasive medial percutaneous locking Plate osteosynthesis for the treatment of Pilon fracture can effectively decrease iatrogenic soft tissue injury, preserve the blood supply of bone fragments, and gain reduction and fixation of fractures. This technique has less complication rate and good treatment result.
出处
《实用骨科杂志》
2015年第1期26-29,共4页
Journal of Practical Orthopaedics
关键词
PILON骨折
前外侧
切开复位
锁定板
经皮微创接骨术
pilon fracture
anterolateral
open reduction
locking plate
minimally invasive percutaneous plate osteosynthesis
