CAJ | 학술논문

目的探讨多切口多枚小钢板(multiple low-profile plate,MLPP)内固定治疗Rüedi-Allg(o)werⅡ～Ⅲ型pilon骨折的疗效. 方法回顾性分析2007年7月-2012年3月采用多切口MLPP固定治疗且获得随访的21例pilon骨折患者资料.其中Rüedi-Allg(o)werⅡ型7例,Ⅲ型14例.根据X线片及CT显示的骨折折线累及范围选择多个切口,采用MLPP固定骨折.采用Burwell-Charnley影像学评价标准评价复位质量,美国足踝外科协会(American Orthopedic Foot&Ankle Society,AOFAS)踝与后足功能评分评价踝关节及后足功能.统计骨折类型、骨折愈合率、切口并发症发生率. 结果骨折均愈合,骨折复位优良率为95％(20/21);AOFAS评分优11例,良6例,可4例,优良率达81％.无切口感染患者,1例切口开裂,5例发生创伤性关节炎. 结论多切口MLPP固定治疗pilon骨折可减少切口并发症,有利于骨折复位、稳定,以达到早活动、晚负重的要求.
목적 탐토다절구다매소강판(multiple low-profile plate,MLPP)내고정치료Rüedi-Allg(o)werⅡ～Ⅲ형pilon골절적료효. 방법 회고성분석2007년7월-2012년3월채용다절구MLPP고정치료차획득수방적21례pilon골절환자자료.기중Rüedi-Allg(o)werⅡ형7례,Ⅲ형14례.근거X선편급CT현시적골절절선루급범위선택다개절구,채용MLPP고정골절.채용Burwell-Charnley영상학평개표준평개복위질량,미국족과외과협회(American Orthopedic Foot&Ankle Society,AOFAS)과여후족공능평분평개과관절급후족공능.통계골절류형、골절유합솔、절구병발증발생솔. 결과 골절균유합,골절복위우량솔위95％(20/21);AOFAS평분우11례,량6례,가4례,우량솔체81％.무절구감염환자,1례절구개렬,5례발생창상성관절염. 결론 다절구MLPP고정치료pilon골절가감소절구병발증,유리우골절복위、은정,이체도조활동、만부중적요구.
Objective To assess the outcome of fixation of Rüedi-Allg(o)wer type Ⅱ and Ⅲ pilon fracture using multiple low-profile plates (MLPP) via multiple incisions.Methods A retrospective study was made on 21 cases of pilon fracture immobilized using MLPP via multiple incisions between July 2007 and March 2012.There were 7 cases of Rüedi-Allgower type Ⅱ and 14 type Ⅲ.Fractures were reduced and fixed based on X-ray films and CT scans for fracture line and effect area.Quality of reduction was evaluated by Burwell-Charnley radiological score.Ankle and hindfoot functions were evaluated by American Orthopedic Foot & Ankle Society ankle-hindfoot scale.Fracture types,healing rate,and wound complication incidence were recorded.Results All fractures were healed,with the excellence rate of 95％ (20/21).According to AOFAS score,the results were rated as excellent in 11 cases,good in 6,fair in 4,with the excellence rate of 81％.None suffered from wound infection,except for wound dehiscence in 1 case and traumatic arthritis in 5.Conclusion Treatment of pilon fractures by MLPP via multiple incisions can reduce wound complications,promote reduction and stabilization of fracture,and satisfy the demand of early movement and late weight bearing of the ankle.