Pilon骨折三种不同治疗方法疗效探讨

目的探讨Pilon骨折的三种不同治疗方法临床适应证及其疗效评价。方法对2000年2月至2006年3月间治疗的63例Pilon骨折患者进行回顾性分析。其中开放性损伤15例，闭合性损伤48例。根据骨折类型与周围软组织损伤程度，分别采用三种不同治疗方法：跟骨牵引加小夹板固定组（29例）均为闭合性骨折，内固定组（23例），外固定器组（11例）。结果所有患者均获得随访，随访8～31个月（平均15．3个月），骨愈合时间8～14周，平均10周。按Helfet疗效评价标准，本组优良者57例（90．5％），其中Ⅰ型骨折优良者26例，Ⅱ型骨折优良者15例，Ⅲ型骨折优良者16例。结论根据骨折类型及软组织条件，恰当选择固定方法是取得Pilon骨折满意疗效的关键，可有效避免并发症的发生。

Study of Three Different Ways in the Treatment of Pilon Fracture

Objective To elucidate the choice of three defferent ways as well as the clinical efficacy in the treatment of Pilon fracture and different damages of skin and tissue. Methods 29 cases were treated with calcaneum bone traction and small splinting,23 cases were treated with internal fixation, 11 cases were treated with external fixation of Ilizarov. Results All cases were followed up for 8431 months （15.3 months average）. According to Heifer criterion, the results were evaluated as the total excellent and good outcome accounted for 90.5%. Conclusion The key point of treatment is rational selection of three defferent ways in the treatment of Pilon fracture according to the typle of Pilon fracture and different damages of skin and tissue.