手法复位外固定架结合有限内固定治疗胫骨Pilon骨折

目的分析手法复位外固定复合有限内固定治疗胫骨Pilon骨折的效果。方法选择81例Pilon骨折患者作为观察组，对其采用手法复位外固定架结合有限内固定治疗，采用手法牵引复位，先上外固定架，然后有限切开胫骨远端，整复固定小骨块和关节面，并选择应用手法复位加骨牵引治疗的同期患者81例作为对照组，对两组的治疗效果以及并发症情况进行比较分析。结果随访时间为8～20个月，依照Helfet评定标准，观察组的治疗优良率为93．83％，对照组的优良率为66．67％，两组差异有统计学意义（P〈0．05）；并发症情况比较，观察组优于对照组（P〈0．05）。结论先行手法复位，再上外固定支架，然后精确复位加有限内固定治疗Pilon骨折，效果满意，并发症少，值得推荐使用。

Manipulative reduction external fixation combined with limited internal fixation in treatment of tibial pilon fracture

Objective To analyze the curative effect of manipulative reduction external fixation combined with limited internal fixation in the treatment of tibial Pilon fracture and summarize experience for clinical treatment. Methods Eighty-one patients with fracture were selected as the observation group and received manipulative reduction external fixation combined with limited internal fixation. After the manipulative traction reduction was used, the external fixa- tor was placed first and then the distal end of tibia was cut open limitedly in order to reconstruct and fix the small bones and articular surface. Eighty-one corresponding patients having received manipulative reduction extemal fixa- tion combined with bone traction treatment were selected as the control group. The curative effect and complications of the two groups were analyzed comparatively. Results The patients were followed up for 8 to 20 months. According to the Helfet assessment standard, the treatment excellent and good rate of the observation group was 93.83% and that of the control group was 66.67%, with statistically significant difference between the two groups （P 〈 0.05）. In terms of the complications, the observation group was superior to the control group （P 〈 0.05）. Conclusion Manipulative re- duction first and then external fixator placement, followed by accurate reduction combined with limited internal fixa- tion shows satisfactory effect and few complications in the treatment of Pilon fracture, thereby worthy of promotion and application.