CAJ | 학술논문

目的评估分阶段延期切开复位内固定治疗严重pilon骨折的临床疗效. 方法 2003年12月至2008年2月收治23例高能量损伤pilon骨折患者,根据Rüedi-Allgower分型:Ⅱ型9例,Ⅲ型14例.所有患者急诊行腓骨切开复位内固定,内侧超踝关节支架临时外固定.7～10 d(平均8 d)后拆除外固定支架,行胫骨远端骨折切开复位内固定. 结果所有患者均获得随访,时间13～34个月,平均25个月.骨折愈合时间8～30周,平均18周,按照Teeny和Wiss等踝关节功能评分系统评分:优13例,良7例,可2例,差1例,优良率为86.9%.2例术后出现局部软组织并发症,包括1例皮肤坏死,1例切口浅表感染,通过换药后治愈. 结论分阶段治疗严重pilon骨折能有效降低软组织并发症,提高关节面的复位质量.
목적 평고분계단연기절개복위내고정치료엄중pilon골절적림상료효. 방법 2003년12월지2008년2월수치23례고능량손상pilon골절환자,근거Rüedi-Allgower분형:Ⅱ형9례,Ⅲ형14례.소유환자급진행비골절개복위내고정,내측초과관절지가림시외고정.7～10 d(평균8 d)후탁제외고정지가,행경골원단골절절개복위내고정. 결과 소유환자균획득수방,시간13～34개월,평균25개월.골절유합시간8～30주,평균18주,안조Teeny화Wiss등과관절공능평분계통평분:우13례,량7례,가2례,차1례,우량솔위86.9%.2례술후출현국부연조직병발증,포괄1례피부배사,1례절구천표감염,통과환약후치유. 결론 분계단치료엄중pilon골절능유효강저연조직병발증,제고관절면적복위질량.
Objective To evaluate the two-staged treatment of types Ⅱ and Ⅲ pilon fractures. Methods From December 2003 to February 2008, 23 severe cases of pilon fractures underwent emergent were 9 cases of type Ⅱ, and 14 type Ⅲ. After the external fixation for 7 to 10 days (average, 8 days), the fixators were removed and the patients underwent open reduction and internal plating. Results All pa-tients were available for an average follow-up of 25 months (range, 13 to 34) after surgery. All fractures healed at an average of 18 weeks (range, 8 to 30) postoperatively. There were 13 excellent cases, 7 good, 2 fair, and 1 poor according to the ankle scoring of Teen and Wiss. The complications included skin necrosis in 1 case and wound superficial infection in 1 case, which were successfully treated by local changes of dressing. Conclusion The two-stage treatment protocol for severe pilon fractures can decrease soft tissue compli-cations and improve articular anatomical reconstruction.