严重Pilon骨折的手术治疗方法探讨

目的探讨治疗Ruedi—Allgowerm型Pilon骨折的方法。方法对18例Ruedi—Allgowernl型Pilon骨折患者采用切开复位钢板内固定和切开复位有限内固定结合外固定两种方法进行治疗。结果切开复位钢板内固定8例，优3例，良2例，可1例，差2例，优良牢62．5％；切开复位有限内固定结合外固定10例，优4例，良4例，可1例，差1例，优良率80％。结论影响Ruedi—AllgowerIII型Pilon骨折疗效的因素不仅同骨折的整复和固定有关，更重要的是如何避免软组织并发症的发生。应根据骨折情况的不同，选用不同的固定方法，才能取得理想的疗效。切开复位有限内固定结合外固定技术可有效防止软组织并发症，是治疗Ruedi—AllgowerltI型Pilon骨折较好的方法。

Discussion of the operation of severe Pilon fracture

Objective To evaluate the operation treating of Ruedi - Allgower m or the Pilon fracture. Methods Using the internal fixation with steel plate and limited internal fixation combining with external fixation respectively to treat our patients. Results Open reduction and internal fixation in 8 case,excelleut in 3 cases,good in 2 eases,fair in l and poor in 2 cases, the fine rate was 62.5 %. Open reduction and limited internal fixation combined with external fixation in 10 cases, excel- lent in 4 cases, good in 4 cases, fair in l and poor in 1 cases, good rate was 80%. Conclusion Factors influence the prognosis of Ruedi - Allgower III of the Pilon fracture associate is not only with the reduction and fixation, but more importantly with the avoidance of soft tissue complications during and after the surgery. So choose the feasible operation according different fracture is the way to get an ideal prognosis. Being contrasted, limited internal fixation combining with external fixation can effectively avoid the soft tissue complications and could be a better operation to treat Ruedi - Allgower III of the Pilon fracture.