锁定钢板治疗胫骨Pilon骨折的疗效分析

目的探讨锁定钢板治疗胫骨Pilon骨折的临床疗效。方法 2007-2009年共收治胫骨Pilon骨折58例患者,其中男37例,女21例;年龄19-64岁,平均39.3岁。根据Pilon骨折Rüedi-Aoellower分型,其中型18例,型26例,型14例。开放性骨折13例,按Gustilo分型,型6例,型5例,型2例。Rüedi-Aloelgower型及部分型骨折（18例）共36例患者行有限切开微创锁定钢板内固定术;Rüedi-Aloelgower型（8例）及型骨折患者共22例行切开复位内固定、植骨术。结果随访时间14-23个月,平均21个月。骨折愈合时间9-26周,平均12周。无骨不愈合病例。根据Mazur评分系统,优38例,良13例,可5例,差2例,优良率为87.9%。结论锁定钢板结合微创技术治疗胫腓骨远端骨折已逐渐达成共识,并取得满意疗效,但胫腓骨远端粉碎性骨折的手术治疗没有固定模式,对具体患者需结合骨折类型、开放性损伤的程度等综合判断。

The Clinical Effect of the Comminute Fracture of Distal Tibia-Fibular Fracture with the Usage of Locking Compression Plate(LCP)

Objective To explore the clinical effect of the comminute fracture of distal tibia-fibular fracture with the usage of locking compression plate（LCP）.Methods 58 cases of distal tibia-fibular commute fracture were followed up from 2007 to 2009,including of 37 male cases and 11 female cases,with the average of 39.3 years old） from 19 to 64.According to Rüedi-Allgo¨wer Pilon fracture scale,typeⅠ 18 cases,type Ⅱ26 cases and type Ⅲ14 cases.Open fracture 13 cases,in which type Ⅰ6 cases,type Ⅱ5 cases,type Ⅲ 2 cases,according to Gustilo scale.Techniques of Minimally invasive percutaneous plate osteosynthesis（MIPPO） were used for the treatment of 36 cases,which included of all the cases）.Open reduction and internal fixation and bone-graft were used for the Rüedi-Allgo¨wer typeⅠcases and part of Rüedi-Allgo¨wer type Ⅱ cases（18 treatment of 22 cases,including of the remain Rüedi-Allgo¨wer typeⅡcases（8 cases） and Rüedi-Allgo¨wer type Ⅲ cases.Results the average follow-up period was 21months from 14 to 23 months.The average time of healing fracture was 12 weeks,from 9 to 26 weeks.No ununion were found during the follow up.According to Mazur scale,the results were evaluated as excellent in 38 cases,good in13 cases,fair in 5 cases and poor in 2 cases.The rate of excellent and good was 87.9%.Conclusion The treatment of distal tibial-fibular fracture（Pilon fracture） with the usage of locking compression plate and MIPPO technique were commonly realized,as well as the satisfactory curative effect were got.Even so,no unique method were used for the treatment of the distal tibia-fibular fracture,thus,should be judged by the type of fracture and the degree of open injyry.