复杂Pilon骨折的分期治疗

目的探讨应用分期治疗复杂Pilon骨折的临床效果。方法笔者2009年6月~2012年12月应用一期外固定架固定、二期更换内固定治疗复杂Pilon骨折18例,男性13例,女性5例;年龄31~55岁,平均42.6岁。右侧9例,左侧7例,双侧2例。结果本组无深部感染病例,8例皮缘坏死、浅表感染经换药愈合。随访时间16~24个月,平均18个月;骨折平均愈合时间6个月,无内固定松动、断裂,踝关节屈伸活动较满意。结论合理的分期治疗是复杂Pilon骨折安全有效的治疗手段。

Staging treatment of complex Pilon fracture

Objective To investigate the clinical effect of treating complex Pilon fractures by stages . Methods From Jun.2009 to Dec.2012,18 cases13 males and 5 females ranged from 31-55 (average,42.6) years]of complex Pilon fracture were applied external fixation in the first stage and replaced fixation in the second stage.Nine cases had fractures on the right side ,7 had on the left,and 2 had on both sides.Results There was no case of deep infection .Eight cases developed skin necrosis and superficial infection , which were cured by dressing change.All the 18 patients obtained a mean follow-up of 18 months(16-24 months).All the fractures healed and the average healing time was 6 months.No internal fixation loosening ,fracture or other complication occurred .The ankle flexion and extension activities were satisfactory .Conclusion Rational staging is a safe and effective method for the treatment of complex Pilon fracture .