胫骨远端锁定加压钢板治疗高能量Pilon骨折

目的探讨胫骨远端锁定加压钢板(LCP)治疗高能量Pilon骨折的临床疗效。方法对30例高能量Pilon骨折均行胫骨远端LCP内固定术,其中25例应用MIPPO技术治疗。结果 29例切口一期愈合,1例出现2 mm的切口边缘坏死,经换药后愈合。30例均获随访,时间8~16个月。骨折愈合时间8~24周。根据Teeny-Wiss评分系统进行评定,踝关节功能:优24例,良4例,可2例,优良率为93.3%;放射学评价:优17例,良9例,可4例,优良率86.7%。结论胫骨远端LCP治疗高能量Pilon骨折疗效满意,但应注重术前软组织处理,术中采取正确的骨折固定顺序,术后及时进行合理的功能锻练。

Locking compression plate for treatment of severe Pilon fracture

Objective To explore the clinical curative effect of treating severe Pilon fractures by locking compression plate（LCP）. Methods 30 cases of severe Pilon fractures were treated with LCP, including 25 cases with MIPPO technology. Results 29 cases got postoperative incision primary healing, 1 case of small incision necrosis occurred in 2 mm,healed after dressing change. The follow-up period was from 8 to 16 months. The time of healing fracture was from 8 to 24 weeks. According to Teeny-Wiss scale system, the results were evaluated as excellent in 24 cases, good in 4, fair in 2. The rate of excellent and good was 93.3%. Radiologieal evaluation was excellent in 17 cases ,good in 9 ,fair in 4. The rate of excellent and good was 86.7%. Conclusions The clinical curative effect of severe Pilon fractures with LCP is satisfactory, but consideration should be given to the soft tissue treatment before operation. It is needed to take the correct intraoperative fixation order, timely and proper postoperative function training.