CAJ | 학술논문

目的回顾性评估支撑钢板治疗后侧pilon骨折的临床疗效. 方法 2005年1月-2009年12月,通过支撑钢板治疗16例后侧pilon骨折,其中男11例,女5例；平均年龄37.6岁(23～62岁).患者术前均行X线片、CT及三维重建检查.根据CT显示的骨折线累及范围选用后外侧入路或联合入路(后内侧加后外侧)复位固定后踝骨块.术后通过临床检查及X线片随访,临床评估采用美国足踝外科协会(AOFAS)踝-后足评分和视觉模拟评分(visual analogue scale,VAS). 结果根据术前CT扫描将后侧pilon骨折分为三型.14例患者获得随访,平均时间37.6个月(16～52个月),平均AOFAS评分为86.4分(70～98分),平均VAS评分为1.4分(0～3分).1例术后2年仍有踝周肿胀和长期行走不适,其余患者均功能恢复良好,未发现内固定失败. 结论支撑钢板治疗后侧pilon骨折临床疗效肯定,患者可以早期负重功能锻炼.
목적 회고성평고지탱강판치료후측pilon골절적림상료효. 방법 2005년1월-2009년12월,통과지탱강판치료16례후측pilon골절,기중남11례,녀5례；평균년령37.6세(23～62세).환자술전균행X선편、CT급삼유중건검사.근거CT현시적골절선루급범위선용후외측입로혹연합입로(후내측가후외측)복위고정후과골괴.술후통과림상검사급X선편수방,림상평고채용미국족과외과협회(AOFAS)과-후족평분화시각모의평분(visual analogue scale,VAS). 결과 근거술전CT소묘장후측pilon골절분위삼형.14례환자획득수방,평균시간37.6개월(16～52개월),평균AOFAS평분위86.4분(70～98분),평균VAS평분위1.4분(0～3분).1례술후2년잉유과주종창화장기행주불괄,기여환자균공능회복량호,미발현내고정실패. 결론 지탱강판치료후측pilon골절림상료효긍정,환자가이조기부중공능단련.
Objective To retrospectively assess clinical outcomes of buttress plating in fixation of posterior pilon fractures.Methods The study involved 16 cases of posterior pilon fractures that had undergone buttress plate fixation between January 2005 and December 2009.There were 11 males and 5 females,at mean age of 37.6 years (range,23-62 years).All cases received radiography,CT scan and three-dimensional reconstruction preoperatively.Posterior malleolar fragments were reduced and fixed through posterolateral approach or combined approach (posteromedial plus posterolateral approaches) based on effect area of fracture line on CT films.Clinical and radiographic examinations were performed in postoperative follow-up.Clinical outcomes were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS).Results Posterior pilon fractures were classified into 3 types according to CT scans.Fourteen cases were followed up for average 37.6 months (range,16-52 months).Mean AOFAS score was 86.4 points (range,70-98 points) and mean VAS score was 1.4 points (range,0-3 points).All cases received favorable functional outcomes without hardware failure,except that one patient still suffered from peri-ankle swelling and long term walking discomfort two years after operation.Conclusion Buttress plating is effective in treatment of posterior pilon fractures and can facilitate early weight-bearing functional exercise.