CAJ | 학술논문

目的：总结胫骨远端双钢板治疗累及胫距关节的胫骨远端复杂骨折（ Pilon骨折）的手术方法及临床效果。方法采用胫骨远端前外侧锁定加压钢板联合胫骨内侧重建钢板进行内固定治疗C2、C3型复杂 Pilon骨折20例，所有病例均先对腓骨骨折采取切开复位内固定。结果20例均获得随访，时间6～24个月，18例切口一期愈合，2例切口经换药、理疗获得二期愈合，所有骨折均骨性愈合。按Mazur评定标准：优12例，良5例，可3例。结论胫骨远端前外侧锁定加压钢板联合胫骨内侧重建钢板治疗C2、C3型复杂Pilon骨折能有效防止再塌陷与骨折块移位，固定牢靠，是一种有效的内固定方法。
목적：총결경골원단쌍강판치료루급경거관절적경골원단복잡골절（ Pilon골절）적수술방법급림상효과。방법채용경골원단전외측쇄정가압강판연합경골내측중건강판진행내고정치료C2、C3형복잡 Pilon골절20례，소유병례균선대비골골절채취절개복위내고정。결과20례균획득수방，시간6～24개월，18례절구일기유합，2례절구경환약、리료획득이기유합，소유골절균골성유합。안Mazur평정표준：우12례，량5례，가3례。결론경골원단전외측쇄정가압강판연합경골내측중건강판치료C2、C3형복잡Pilon골절능유효방지재탑함여골절괴이위，고정뢰고，시일충유효적내고정방법。
Objective To summarize the operative procedures of complex Pilon fractures and the clinical result of using doub -le distal tibial plate for complex Pilon fractures .Methods 20 cases of type C2 and C3 complex Pilon fractures were treated with an-terolateral distal tibial locking compression plate combined with medial tibial reconstruction plate .All cases with fibular fractures were treated with open reduction and internal fixation first .Results 20 cases were followed up for 6 to 24 months, incision got primary wound healing in 18 cases,incision got delayed wound healing by physics therapy and dress changing in 2 cases.All distal tibial frac-tures achieved solid bony union.According to the Mazur criteria,the results were evaluated as excellent in 12 cases,good in 5,and fair in 3.Conclusion Internal fixation with double distal tibial plate for type C 2 and C3 complex Pilon fractures can prevent resubsidence and fractures displace effectively and can get reliable fixation .It is an effective internal fixation method .