三叶草型固定板治疗胫骨Pilon骨折
摘要
目的 探讨三叶草型固定板治疗胫骨Pilon骨折的临床疗效。
方法 对在2002年3月～2003年7月于中国医科大学第一临床学院骨科和北京空军总医院骨科接受三叶草型固定板治疗的10例闭合性Pilon骨折患者进行随访。采用Rüedi-Allg(?)wer分类方法对Pilon骨折进行分类：Ⅰ型1例，Ⅱ型4例，Ⅲ型5例。术后平均随访9个月(4～18个月)。
结果 疗效评定标准采用Mazur等制定的踝关节症状与功能评分系统。优秀5例；良好4例；一般1例；较差0例。术后并发症包括创口感染1例，骨折延迟愈合1例，踝关节肿胀3例。
结论 选择合适的手术治疗时间，应用塑型良好的三叶草型固定板治疗胫骨Pilon骨折可以获得良好疗效。
Objective: To evaluate the effect of treatment of tibial Pilon fracture with cloverleaf plate.
Methods: Ten cases of closed Pilon fracture were treated through typical ORIF (open reduction and internal fixation) with cloverleaf plate between 2002 and 2003. According to the Ruedi-Allgower classification, there were 1 case of type I fracture, 4 cases of type II fracture and 5 cases of type III fracture. The average period of follow-up was 9 months(4-1 Smonths).
Result: Using the Mazur's criterion of ankle joint, we got result of excellent in 5 cases, good in 4 cases and fair in 1 case. No poor result was found. Complications included infection in 1 case, delayed union in 1 case and swell of ankle joint in 3 cases.
Conclusion: Selecting good time to operation through ORIF and using cloverleaf plate are effective methods to improve the clinical results of tibial Pilon fracture.
方法 对在2002年3月～2003年7月于中国医科大学第一临床学院骨科和北京空军总医院骨科接受三叶草型固定板治疗的10例闭合性Pilon骨折患者进行随访。采用Rüedi-Allg(?)wer分类方法对Pilon骨折进行分类：Ⅰ型1例，Ⅱ型4例，Ⅲ型5例。术后平均随访9个月(4～18个月)。
结果 疗效评定标准采用Mazur等制定的踝关节症状与功能评分系统。优秀5例；良好4例；一般1例；较差0例。术后并发症包括创口感染1例，骨折延迟愈合1例，踝关节肿胀3例。
结论 选择合适的手术治疗时间，应用塑型良好的三叶草型固定板治疗胫骨Pilon骨折可以获得良好疗效。
Objective: To evaluate the effect of treatment of tibial Pilon fracture with cloverleaf plate.
Methods: Ten cases of closed Pilon fracture were treated through typical ORIF (open reduction and internal fixation) with cloverleaf plate between 2002 and 2003. According to the Ruedi-Allgower classification, there were 1 case of type I fracture, 4 cases of type II fracture and 5 cases of type III fracture. The average period of follow-up was 9 months(4-1 Smonths).
Result: Using the Mazur's criterion of ankle joint, we got result of excellent in 5 cases, good in 4 cases and fair in 1 case. No poor result was found. Complications included infection in 1 case, delayed union in 1 case and swell of ankle joint in 3 cases.
Conclusion: Selecting good time to operation through ORIF and using cloverleaf plate are effective methods to improve the clinical results of tibial Pilon fracture.
引文
[1] Ruedi TP, Allgower M. Fracture of the lower end of the tibia into the ankle joint[J].Injury, 1969, 1:92-99
[2] Tracy Watson J, Moed BR, Karges DE, et al. Pilon fracture: Treatment protocol based on severity of soft tissue injury[J]. Clin Orthop, 2000, 375 (6): 78-90
[3] Mazur JM, Schwartz E, Simon SR. Ankle arthrodesis: long-term follow-up with gait analysis[J]. J Bone Joint Surg Am, 1979, 61:964-975
[4] Michael Sirkin and Roy Sanders. The treatment of pilon fractures[J]. Foot and Ankle, 2001, 32 (1): 91-102
[5] Hak-Sun Kim, Jun-Seop Jahng, Sang-Soo Kim, et al. Treatment of tibial pilon fractures using ring fixators and arthroscopy[J]. Clin Orthop, 1997, 334 (1): 244-250
[6] Lawrence Marsh L, Susan Bonar, Nepola J V, et al. Use of an articulated external fixator for fractures of the tibial plafond[J]. J Bone Joint Surg Am, 1995, 77 (10): 1498-1509
[7] Rocco Barbieri, Richard Schenk, Kenneth Koval, et al. Hybrid external fixation in the treatment of tibial plafond fractures[J]. Clin Orthop, 1996, 332 (11): 16-22
[8] Sirkin M, Sanders R, DiPasquale T, et al. A staged protocol for soft tissue management in the treatment of complex pilon fractures[J]. J Orthop Trauma, 1999, 13 (12): 78-84
[9] Patterson M J and Cole J D. Two-staged delayed open reduction and internal fixation of severe pilon fractures[J]. J Orthop Trauma, 1999, 13 (12): 85
[2] Tracy Watson J, Moed BR, Karges DE, et al. Pilon fracture: Treatment protocol based on severity of soft tissue injury[J]. Clin Orthop, 2000, 375 (6): 78-90
[3] Mazur JM, Schwartz E, Simon SR. Ankle arthrodesis: long-term follow-up with gait analysis[J]. J Bone Joint Surg Am, 1979, 61:964-975
[4] Michael Sirkin and Roy Sanders. The treatment of pilon fractures[J]. Foot and Ankle, 2001, 32 (1): 91-102
[5] Hak-Sun Kim, Jun-Seop Jahng, Sang-Soo Kim, et al. Treatment of tibial pilon fractures using ring fixators and arthroscopy[J]. Clin Orthop, 1997, 334 (1): 244-250
[6] Lawrence Marsh L, Susan Bonar, Nepola J V, et al. Use of an articulated external fixator for fractures of the tibial plafond[J]. J Bone Joint Surg Am, 1995, 77 (10): 1498-1509
[7] Rocco Barbieri, Richard Schenk, Kenneth Koval, et al. Hybrid external fixation in the treatment of tibial plafond fractures[J]. Clin Orthop, 1996, 332 (11): 16-22
[8] Sirkin M, Sanders R, DiPasquale T, et al. A staged protocol for soft tissue management in the treatment of complex pilon fractures[J]. J Orthop Trauma, 1999, 13 (12): 78-84
[9] Patterson M J and Cole J D. Two-staged delayed open reduction and internal fixation of severe pilon fractures[J]. J Orthop Trauma, 1999, 13 (12): 85