53例Pilon 骨折手术与非手术治疗方法的比较

目的：通过Pilon骨折不同治疗方法的分析，探讨如何提高其疗效。方法：1998－1999年共治疗Pilon骨折53例，其中保守治疗（包括石膏固定或跟骨牵引）25例，另28例行解剖重建、坚强内固定和植骨的方法。根据每例患者各自的骨折形态及参照健侧胫骨内侧面的弧度，设计相应长度的特制钢板。结果：手术治疗较保守治疗优良率由36．8％提高至89．3％，术后并发症也有明显减少。结论：术前周密设计、特制钢板的应用，以及解剖复位和坚强的内固定，是提高Pilon骨折疗效的有效措施。

Comparison of operation with nonoaperation in treatment of 53 patients with Pilon fracture

Objective To evaluate the effect of treatment of Pilon fractures. Methods Fifty three cases of Pilon fractures were treated during 1988 to 1999; 25 cases were treated conservatively with plaster cast or calcaneal traction, surgical intervention with anatomical reconstruction, stable fixation and bone graft was used in 28 cases. For each case of this group a specific steel plate was produced referring to the configuration of fracture respectively. Results Good to excellent results were obtained in 89% patients of the surgical group, compared with 40% of the conservative group. The complication rate decreased significantly. Conclusions Preoperative careful design , utilization of specific plates and anatomical reduction and stable fixation are effective methods to improve the clinical results of Pilon fractures.