三叶钢板治疗Pilon骨折的初步体会

[目的]评价三叶草钢板治疗Pilon骨折的临床疗效及CPM在术后踝关节功能康复训练中的作用.[方法]分析本院自1999年7月2003年12月收住的42例Pilon骨折按Ruedi-Allgower分型,采用切开复位三叶草钢板内固定治疗,术后早期应用连续被动运动（continuous passive motion,CPM）加强踝关节功能训练.[结果]术后随访14～60个月,踝关节功能根据Bourne标准评判,42例患者总优良率85.7%.并发症主要有：6例伤口浅表感染,2例发生深部感染,1例因伤口张力大而未闭合,2例发生踝关节严重创伤性关节炎.[结论]临床治疗效果与骨折类型以及治疗方法有关,运用三叶草钢板结合CPM治疗Pilon骨折可取得满意的疗效.     

Pilon骨折手术治疗体会

目的探讨Pilon骨折手术治疗方法及疗效。方法对2001年2月至2006年4月接受手术治疗的46例Pilon骨折患者的临床资料进行回顾性分析。按Ruedi-Allgower骨折类型和软组织损伤程度将46例分成两组,A组17例,为Ⅰ型及Ⅱ型软组织损伤较轻者,采用切开复位解剖接骨板内固定治疗;B组29例为Ⅱ型及Ⅲ型软组织损伤严重者,行两阶段分步治疗。结果46例均获得随访,随访时间8～60个月,平均30个月。46例均骨性愈合。A组Ⅰ型、Ⅱ型优良率分别为85.7%、80%,B组Ⅱ型、Ⅲ型优良率分别为78.6%、60%。结论根据骨折情况及软组织损伤程度选择适宜的治疗及手术时机是Pilon骨折取得良好治疗效果的关键。     

Pilon骨折的手术治疗体会

目的探讨Pilon骨折手术治疗采用内固定方法的选择。方法回顾性分析本院自2006年1月至2009年6月间采用胫骨远端外侧异型钢板或AO三叶草钢板手术内固定治疗Ⅱ型、Ⅲ型Pilon骨折46例,其中Ⅱ型34例、Ⅲ型12例。结果经6个月～3年的术后随访,临床疗效优良率达89．1％,其中胫骨远端外侧异型钢板手术固定者达90．6％,AO三叶革钢板固定达85．7％。结论针对Ⅱ型、Ⅲ型Pilon骨折的骨折块状况,应结合软组织的损伤程度,合理选用内固定方法,可达到骨折的稳妥固定,具有早期关节活动,利于骨折愈合的优点。     

18例Pilon骨折的诊治体会

目的：分析采用不同方法治疗不同类型Pilon骨折的效果，探讨Pilon骨折治疗方法的选择。方法：对18例pilon骨折，采用Ruedi--Allgower法进行分类，I型骨折以克氏针或松质骨螺钉固定，Ⅱ型骨折以“T”钢板固定，I型骨折以跨关节外固定架固定。结果：平均随访3年7个月，骨折全部达骨性愈合，按Mazur评价标准，优6例，良7例，可4例，差1例。结论：Pilon骨折的治疗方法应根据其骨折类型来决定。     

Pilon骨折18例治疗体会

目的为探讨Pilon骨折治疗方法及临床疗效。方法回顾分析2005-10—2008-10,采用切开复位钢板内固定术治疗Pilon骨折18例。结果 16例获得随访,随访时间4个月～3 a,平均20个月,骨折愈合时间8～29周,平均12.7周,优12例(66.7%),良4例(22.2%),可1例(5.6%),差1例(5.5%),优良率88.9%。结论认为Pilon骨折可综合多种方法,减少局部并发症以获取较少的踝关节功能,在满足局部生物力学要求内固定术后早期功能锻炼促进肢体远端血液和淋巴的循环,消除肢体肿胀可改善关节软骨细胞营养代谢,减少创伤性关节炎发生。     

复杂Pilon骨折的治疗

[目的]探讨Ⅲ型Pilon骨折的治疗方法和并发症防治。[方法]1996年1月-2004年1月通过手术治疗Ⅲ型Pilon骨折26例，根据不同情况分别采用钢板内固定，有限内固定结合外固定架固定治疗。[结果]26例全部获得随访，随访时间6—24个月，平均13个月。按Mazur评分标准，优9例，良14例，可2例，差1例。[结论]正确选择手术时机，术中良好复位，选择合适的治疗方法是手术成功的关键。     

Pilon骨折20例手术治疗体会

目的 探讨Pilon骨折的手术方法及手术时机的选择.方法 回顾性分析根据骨折分型和软组织损伤程度应用不同内固定方法手术治疗的20例Pilon骨折病例.结果 所有病例临床观察平均18个月,均骨性愈合,Ruediand-Allgawer Ⅰ型优良率为100%,Ⅱ性型优良率为80%,Ⅲ型优良率67%.结论 根据患者年龄、全身状况,骨折及关节面软骨、软组织损伤程度等不同因素,选择适宜手术方法及手术时机治疗Pilon骨折,疗效满意.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

Pilon骨折20例手术治疗体会

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.     

胫骨Pilon骨折的手术治疗

目的 探讨胫骨Pilon骨折的治疗方法、手术时机、手术方法。方法 随访1997年～2002年治疗的胫骨Pilon骨折16例，平均随访28．2个月。骨折类型：Ⅰ型3例，Ⅱ型5例，Ⅲ型8例。手术方法：合并腓骨骨折12例，占80％，均用钢板固定。胫骨骨折：螺钉固定5例，三叶草钢板固定5例，胫骨远端钢板固定2例，一期行踝关节融合3例。结果 按Mazur踝关节症状与功能评分系统评分：优5例，良5例，可3例，差3例。总体优良率为64％，并发症为31％。结论 对大部分Pilon骨折主张施行有限手术、有限内固定。而对严重胫骨关节面粉碎骨折的Ⅲ型骨折宜一期融合。     

Pilon骨折手术治疗体会

Pilon骨折是累及关节面的胫骨远端骨折,占下肢骨折的1%～5%.特别是在高能量损伤情况下,出现关节面嵌压,胫骨下1/3及腓骨远端粉碎性骨折,同时可伴有严重的软组织挫伤,临床上处理较为困难.本院1999年7月至2002年10月,手术治疗19例pilon骨折患者,效果满意.现报告如下.     

复杂Pilon骨折的手术治疗

目的探讨R櫣ediⅢ型Pilon骨折的手术疗效。方法2001年3月至2004年7月手术治疗R櫣ediⅢ型Pilon骨折37例。均采用内固定治疗。结果本组37例均获得了随访。按Mazur标准评分,优30例,良2例,可3例,差2例。结论良好的解剖复位,是治疗Pilon骨折成功的关键。