切开复位内固定治疗后Pilon骨折疗效分析
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摘要
目的探讨手术治疗后Pilon骨折的临床疗效。方法 2016年1月～2017年12月我院收治后Pilon骨折患者9例,其中Ⅰ型4例,Ⅱ型3例,Ⅲ型2例,均行切开复位内固定术。结果本组9例患者均获得随访,平均随访时间17.2(12～24)个月,均获得骨性愈合,平均骨折愈合时间7.1(3～12)个月。8例伤口一期愈合, 1例伤口延迟愈合,经换药处理后愈合良好。采用AOFAS的踝关节-后足评分标准进行疗效评估,平均81.8(63～95)分。末次随访时2例患者出现了创伤性关节炎,踝关节活动轻度受限,长距离行走疼痛。结论切开复位内固定手术治疗后Pilon骨折效果确切,术后可早期功能锻炼,并发症少。
Objective To explore the clinical effect of surgical treatment of posterior Pilon fractures. Method The clinical data of 9 cases with posterior Pilon fractures treated by open reduction and internal fixation from January 2016 to December 2017 in our hospital were analyzed retrospectively, including 4 cases of type Ⅰ, 3 cases of type Ⅱ and 2 cases of type Ⅲ. Results All 9 cases were followed up for 12 to 24 months with an average of 17.2 months.Bone union was achieved in all cases during 3 to 12 months(average 7.1 months).Eight cases gained the wound healing in one stage, and one case was found wound delayed healing and healed well after dressing change. According to the Ankle & Hindfoot scale of American Orthopaedic Foot and Ankle Society(AOFAS), the mean score was 63 to 95 with an average of 81.8.At the last follow-up, 2 patients developed traumatic arthritis. Conclusion The surgical intervention of open reduction and internal fixation can achieve an reliable effect for posterior Pilon fractures with early postoperative functional exercise and fewer complications.
Objective To explore the clinical effect of surgical treatment of posterior Pilon fractures. Method The clinical data of 9 cases with posterior Pilon fractures treated by open reduction and internal fixation from January 2016 to December 2017 in our hospital were analyzed retrospectively, including 4 cases of type Ⅰ, 3 cases of type Ⅱ and 2 cases of type Ⅲ. Results All 9 cases were followed up for 12 to 24 months with an average of 17.2 months.Bone union was achieved in all cases during 3 to 12 months(average 7.1 months).Eight cases gained the wound healing in one stage, and one case was found wound delayed healing and healed well after dressing change. According to the Ankle & Hindfoot scale of American Orthopaedic Foot and Ankle Society(AOFAS), the mean score was 63 to 95 with an average of 81.8.At the last follow-up, 2 patients developed traumatic arthritis. Conclusion The surgical intervention of open reduction and internal fixation can achieve an reliable effect for posterior Pilon fractures with early postoperative functional exercise and fewer complications.
引文
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[9] 高懋峰,刘乃澄,施卫东,等.后外侧入路支撑钢板内固定治疗后 Pilon骨折的疗效分析[J].中国骨与关节损伤杂志,2018,33(8):817-819.
[2] 俞光荣,陈大伟,赵宏谋,等.支撑钢板固定后侧Pilon骨折的疗效分析[J].中华创伤杂志,2013,29(3):243-248.
[3] 赵宏谋,张言,胡东,等.支撑钢板与螺钉固定治疗旋后-内收型Ⅱ度踝关节骨折的比较研究[J].中国修复重建外科杂志,2017,31(5):553-558.
[4] Haraguchi N,Haruyama H,Toga H,et al.Pathoanatomy of posterior malleolar fractures of the ankle[J].J Bone Joint Surg Am,2006,88(5):1085-1092.
[5] Klammer G,Kadakia AR,Joos DA,et al.Posterior pilon fractures:a retrospective case series and proposed classification system[J].Foot Ankle Int,2013,34(2):189-199.doi:10.1177/1071100712469334.
[6] 林途,刘杰,李少华.后踝骨折及后Pilon骨折的鉴别诊断及治疗进展[J].同济大学学报(医学版),2017,38(6):107-112.
[7] 衡科,张云坤.后方入路治疗后侧Pilon骨折[J].江苏医药,2015( 2):220-222.
[8] 赵荣财,邵林.后Pilon骨折的诊断与治疗进展[J].创伤外科杂志,2015,17(4):373-376.
[9] 高懋峰,刘乃澄,施卫东,等.后外侧入路支撑钢板内固定治疗后 Pilon骨折的疗效分析[J].中国骨与关节损伤杂志,2018,33(8):817-819.