摘要
目的探讨胫骨远端外侧L形解剖锁定钢板治疗胫骨Pilon骨折的临床效果。方法我院2015年5月~2016年4月收治胫骨Pilon骨折患者7例,均行切开复位胫骨远端外侧L形解剖锁定钢板内固定术。左侧4例,右侧3例。按Rüedi-Allgower分型：Ⅰ型1例,Ⅱ型4例,Ⅲ型2例。合并腓骨下段骨折4例,跖骨骨折1例。结果本组7例患者均获随访,平均随访时间10.5（4~16）个月。7例患者均获得骨性愈合,平均愈合时间为9.6（4~15）个月。6例患者伤口一期愈合,1例伤口延迟愈合,经换药处理后愈合良好。踝关节功能采用Mazur评分[2]进行评估：优4例,良2例,可1例,优良率为85.7%。本组均未出现伤口感染、骨髓炎、骨折不愈合等严重并发症。结论应用胫骨远端外侧L形解剖锁定钢板治疗胫骨Pilon骨折临床效果满意,但术前应仔细评估,选择恰当手术时机,制定详细手术计划。
Objective To explore the clinical effect of distal tibial lateral L-shaped anatomical locking compression plate for tibial Pilon fracture. Methods A total of 7 cases with tibial Pilon fractures were treated by open reduction and internal fixation of distal tibial lateral L-shaped anatomical locking compression plate from May 2015 to April 2016 in our hospital,including 4 of left lateral and 3 of right lateral. According to the classification of Rüedi-Allgower,there was 1 case of type Ⅰ,4 cases of type Ⅱ and 2 cases of typeⅢ. Lower fibular fractures were combined in 4 cases and metatarsal fracture in 1 case. Results All 7 patients were followed up for 10. 5 months averagely（ ranged from 4 to 16 months）. All 7 patients achieved bone union during 4 to 15 months（ average 9. 6 months）. One case was found delayed union of the wound and healed well after change dressings,the other 6 cases achieved primary wounds healing. The ankle joint function was assessed by Mazur score[2]： Excellent in 4 cases,good in 2 cases and fair in 1 case,the fineness rate was 85. 7%. There were no serious complications as wound infection,osteomyelitis and fracture nonunion. Conclusion The internal fixation of L-shaped anatomic locking compression plate of distal tibia can achieve reliable effect for tibial pilon fractures based on careful preoperative assessment,appropriate surgical timing and detailed surgical plan.
作者
蒋亮东
陈先礼
汤敬武
杨立军
曾驰
李亮
JIANG Liang-dong CHEN Xian-li TANG Jing-wu YANG Li-jun ZENG Chi LI Liang(Department of Orthopedics and Trauma, Changsha Central Hospital, Changsha 410004 , Hunan , China)
出处
《中国现代手术学杂志》
2016年第5期347-350,共4页
Chinese Journal of Modern Operative Surgery
关键词
胫骨骨折
骨折固定术
内
钢板
tibial fractures
fracture fixation
internal
plate
