漂浮体位下Rüedi-Allgwer Ⅲ型Pilon骨折的治疗

目的探讨采用漂浮体位下双切口联合入路全方位内固定治疗Rüedi-Allgwer Ⅲ型闭合Pilon骨折的疗效。方法上海中医药大学附属曙光医院骨科及陆良县人民医院2012年6月—2015年6月收治的19例Rüedi-Allgwer Ⅲ型单侧闭合性Pilon骨折患者,其中男性11例,女性8例;年龄25~56岁,平均36.5岁。采用前内侧联合后外侧切口复位骨折后进行全方位内固定。术后进行影像学评价及功能评分。结果所有患者术后获随访,平均16.2个月。15例切口一期愈合,4例二期愈合,骨折均愈合,无切口深部感染、断钉或退钉、皮瓣坏死等并发症发生。影像学评价示关节面获得解剖复位满意。功能评分示优良率78.9%。结论采用双切口联合入路全方位内固定治疗Rüedi-Allgwer Ⅲ型闭合Pilon骨折,复位满意,内固定坚强,关节功能恢复良好,并发症少。

Treating Rüedi-Allg?wer typeⅢPilon fractures under floating position

Objective To explore the effectiveness of internal fixation by double approaches for treating Rüedi-Allg?wer type ⅢPilon fractures under the floating position . Methods Nineteen cases of Rüedi-Allg?wer Type Ⅲunilateral closed Pilon fracture patients (11 males and 8 females aged from 25-56 years)were treated with internal fixation by anteromedial and posterolateral approaches from Jun .2012 to Jun.2015.Imaging evaluation and functional scoring were used to assess the effectiveness .Results All patients were followed up for an average of 16.2 months.Operative incisions achieved primary healing in 15 cases and delayed healing in 4 cases.All cases got bone union .No deep infection , broken nail 'withdrawal nail or skin flap necrosis occurred .Imaging evaluation showed satisfactory reductions of articular surface .Functional scoring showed that the excellent and good rate was 78.9％.Conclusion Internal fixation by combied approaches is an effective method to treat R üedi-Allg?we typeⅢPilon fractures with satisfactory reduction , rigid fixation,good joint function recovery and little complication .