CAJ | 학술논문

目的探讨应用分期手术治疗高能量Pilon骨折的临床疗效方法 36例高能量Pilon骨折应用分期手术治疗,患者人院后一期行腓骨骨折切开整复内固定及跟骨牵引,10～14天软组织情况改善后二期行胫骨关节面整复固定.伤后至胫骨关节面手术时间为10～14天,平均12天.结果 32例患者获得随访8～36个月,平均17.3个月,采用Mazur等提出的踝关节症状与功能评分系统进行评分,优18例,良9例,可4例,差1例,优良率84.3%.结论分期手术有利于消肿及二期手术时胫骨关节面的复位,可降低术后感染及皮肤坏死等并发症的发生.
목적 탐토응용분기수술치료고능량Pilon골절적림상료효방법 36례고능량Pilon골절응용분기수술치료,환자인원후일기행비골골절절개정복내고정급근골견인,10～14천연조직정황개선후이기행경골관절면정복고정.상후지경골관절면수술시간위10～14천,평균12천.결과 32례환자획득수방8～36개월,평균17.3개월,채용Mazur등제출적과관절증상여공능평분계통진행평분,우18례,량9례,가4례,차1례,우량솔84.3%.결론 분기수술유리우소종급이기수술시경골관절면적복위,가강저술후감염급피부배사등병발증적발생.
Objective To explore the efficacy of sequential surgery for high-energy Pilon fractures. Methods 36 patients underwent sequential surgery for high-energy Pilon fractures. They received reduction and internal fixation of fibular fracture plus traction of calcaneus for primary treatment 10 to 14 days after the first treatmnt, they received reduction and internal fixation of tibia]articular surface for secondary treatment. The time from fracture occurrence to surgery on tibial articular surface was 10 to 14 days, with an average of 12 days. Results 32 patients were followed up for 8 to 36 months (mean time, 17.3 months). According to the system for scoring and function of the ankle joint by Mazur, 18 patients had an excellent result, 9 better result, 4 receptible result, and 1 bad result, with an ideal outcome rate of 84.3%.Conclusions Sequential surgery is beneficial in reducing edema in the tissue and returning the tibial articular surface to its correct position by the secondary surgery, and it can reduce the incidence of postoperative complications including infection and skin necrosis.