CAJ | 학술논문

目的：探讨胫骨Pilon骨折分期治疗效果。方法：收治胫骨Pilon骨折患者36例，采用Ruedi-Allgower分型：Ⅰ型6例，Ⅱ型18例，Ⅲ型12例。Ⅰ、Ⅱ、Ⅲ型骨折选择胫骨远端内侧解剖锁定钢板或外侧“L”型锁定钢板固定，合并腓骨骨折用管型或腓骨远端解剖钢板。采用 Mazur 评分标准行疗效评定。结果：1例发生骨髓炎，其余无并发症。骨折愈合时间12～28周，平均16周。根据Mazur评分，优18例，良11例，可6例，差1例。结论：骨折发生后予以跟骨牵引、抬高患肢、加强消肿等处理措施，局部软组织改善后，采用二期骨折切开内固定术既能减少局部并发症，又能提供骨折端稳定以进行早期功能锻炼，是提高胫骨Pilon骨折手术疗效的有效措施。
목적：탐토경골Pilon골절분기치료효과。방법：수치경골Pilon골절환자36례，채용Ruedi-Allgower분형：Ⅰ형6례，Ⅱ형18례，Ⅲ형12례。Ⅰ、Ⅱ、Ⅲ형골절선택경골원단내측해부쇄정강판혹외측“L”형쇄정강판고정，합병비골골절용관형혹비골원단해부강판。채용 Mazur 평분표준행료효평정。결과：1례발생골수염，기여무병발증。골절유합시간12～28주，평균16주。근거Mazur평분，우18례，량11례，가6례，차1례。결론：골절발생후여이근골견인、태고환지、가강소종등처리조시，국부연조직개선후，채용이기골절절개내고정술기능감소국부병발증，우능제공골절단은정이진행조기공능단련，시제고경골Pilon골절수술료효적유효조시。
Objective:To explore the staging treatment effect of Pilon fracture of tibia.Methods:36 patients with Pilon fracture of tibia were selected,and they were divided into three types according to Ruedi-Allgower:6 cases of type Ⅰ,18 cases of type Ⅱ,12 cases of type Ⅲ.Distal tibia inside anatomical locking plate or lateral "L" type locking plate fixation were selected for type Ⅰ,Ⅱ,Ⅲ fractures,tube type or anatomic plate of distal fibula were selected for combination of fibula fracture.Efficacy was assessed using Mazur score criteria.Results:1 case had osteomyelitis,there was no other complications.The healing time of fracture was 12 to 28 weeks,and the average was 16 weeks.According to Mazur score,18 cases were excellent,11 cases were good,6 cases were satisfactory,1 case was poor.Conclusion:After the fracture,calcaneus traction,limb elevation,strengthening the swelling and other treatment measures were used,after local soft tissue improvement,the application of fracture open internal fixation at two stage not only can reduce the local complications,but also provide the stability of fracture end in order to carry out early functional exercise, it was an effective measure to improve the surgical effect of Pilon fracture of tibia.