不同类型Pilon骨折的手术治疗

目的分析不同类型Pilon骨折的手术方法和内固定策略。方法对59例Pilon骨折患者（65肢）,根据骨折类型和局部软组织条件,采用松质骨螺钉有限固定28肢,胫骨远端钢板内固定20肢,外固定支架结合螺钉或克氏针固定17肢。结果 65例均获随访,时间8~45个月。应用Mazur评分标准：优33肢,良20肢,可8肢,差4肢,优良率81.5%。结论根据Pilon骨折分型、软组织损伤情况合理采用螺钉、胫骨远端钢板、外固定支架手术固定,恢复关节面的平整,稳定骨折,早期锻炼,均可以获得较好的治疗效果。

Surgical treatment of different types of Pilon fracture

Objective To study the surgical treatment of different types of Pilon fracture.Methods 59 cases(65 limbs) of Pilon fractures were enrolled;According to the fracture configuration and the soft tissue damage situation,28 limbs were treated by screws limited internal fixation,20 limbs with distal tibia plates,and 17 limbs with external fixation and screws or Kirschner wire fixation.Results All cases were followed up for 8~45 months.The results were excellent in 33 limbs,good in 20,fair in 8 and poor in 4,and t...