胫骨远端前外侧切口L-解剖锁定板治疗B_3、C型Pilon骨折

目的探讨胫骨远端前外侧切口L-解剖锁定板固定治疗B3、C型Pilon骨折的疗效。方法应用胫骨远端前外侧切口L-解剖锁定板固定延期(伤后9~19 d)治疗36例B3、C型Pilon骨折患者。伤后早期石膏固定6例,骨牵引11例,腓骨克氏针联合石膏固定11例,跨关节外固定支架固定8例。结果患者均获得随访,时间8~43个月。术后2例出现医源性腓浅神经麻痹,1例闭合骨折出现伤口感染,2例骨折延迟愈合。Olerud-Molander踝关节骨折功能评分:优20例,良11例,可5例,优良率86.1%。SMFA问卷得分0~39(24.7±8.2)分。结论选择胫骨远端前外侧切口解剖复位、L-解剖锁定板坚强固定治疗B3、C型Pilon骨折可获得满意的临床疗效。

Treatment of Pilon type B3 and C fractures with L-anatomical locking plate via anterolateral ;incision of the distal tibia

Objective To investigate the clinical effects of Pilon type B 3 and C fractures treated by L-anatomical loc-king plate fixation via anterolateral incision of the distal tibia .Methods In 9~19 days after injury , 36 patients with Pilon type B3 and C fractures were treated by L-anatomical locking plate fixation via anterolateral incision of the distal tibia.Among them,6 patients were undergone plaster immobilization in early post injury ,11 patients were undergone bone traction,11 patients fibula were fixed with Kirschner wire and plaster and 8 patients were fixed with external fixa-tion.Results All patients were followed up for 8~43 months.There were 2 cases of iatrogenic superficial nerve palsy, 1 case of closed fractures and 2 cases of delayed healing .Olerud-Molander ankle fracture function score:ex-cellent in 20 cases,good in 11,fair in 5,excellent and good rate was 86.1%.SMFA questionnaire scores were 0~39 (24.7 ±8.2) points.Conclusions With anterolateral incision of the distal tibia , L-anatomical locking plate fixation for the treatment of Pilon type B 3 ,C fractures can obtain satisfactory clinical efficacy .