| Pilon骨折手术治疗和内固定选择 |
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Received:October 26, 2008
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李雄峰 |
LI Xiong-feng |
湖州市中心医院骨科,浙江 湖州 313000 |
Huzhou Central Hospital,Huzhou 313000,Zhejiang,China |
lyfwind@126.com |
| 蒋雪生 |
JIANG Xue-sheng |
湖州市中心医院骨科,浙江 湖州 313000 |
Huzhou Central Hospital,Huzhou 313000,Zhejiang,China |
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| 管国华 |
GUAN Guo-hua |
湖州市中心医院骨科,浙江 湖州 313000 |
Huzhou Central Hospital,Huzhou 313000,Zhejiang,China |
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| 黄胜 |
HUANG Sheng |
湖州市中心医院骨科,浙江 湖州 313000 |
Huzhou Central Hospital,Huzhou 313000,Zhejiang,China |
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| 吴猛 |
WU Meng |
湖州市中心医院骨科,浙江 湖州 313000 |
Huzhou Central Hospital,Huzhou 313000,Zhejiang,China |
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| 期刊信息：《中国骨伤》2009年22卷，第8期，第621-623页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：对Pilon骨折的手术治疗和内固定选择进行探讨。
方法：2004年8月至2007年8月治疗Pilon骨折40例， 男30例，女10例；年龄22～63岁，平均(36.52±12.23)岁。其中闭合性骨折30例，开放骨折10例。7例行急诊手术，3例开放骨折先予清创缝合。切开复位单纯解剖钢板内固定23例；而根据骨折情况采用解剖钢板、LC-DCP、重建钢板、克氏针、螺钉等单独或组合固定17例；手术中给以植骨14例。
结果：病例均获得随访，时间6～32个月，平均19个月，骨折平均愈合时间3～5个月。术后按照Baired-Jackson踝关节功能评分标准系统进行评估，结果优27例，良7例，可5例，差1例。术后7例出现切口或创面愈合困难，其中5例为开放骨折Ⅰ期手术病例， 1例为开放骨折Ⅱ期伤口感染，1例为闭合骨折，患者均经换药、清创植皮、皮瓣转移后愈合。
结论：术前对损伤作出正确评估，正确选择手术时机，术中良好复位，根据具体情况选择合适的固定方式是治疗成功的关键。 |
| [关键词]:Pilon骨折 骨折固定术,内 外科手术 |
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| Surgical treatment and the fixator selection for Pilon fractures |
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Abstract:
Objective: To explore the internal fixation selection and the operative method of Pilon fracture.
Methods: From Aug. 2004 to Aug. 2007,there were 40 patients with Pilon fractures involving 30 males and 10 females. Thirty cases were closed fracture and 10 were open fracture. Seven patients were treated by emergency operation,3 patients were debrided and suture at first. Twenty-three patients were treated with open reduction and internal fixation(ORIF),the other seventeen patients were treated with LC-DCP,reconstruct plate for fixation or screw,Kirschner wire combine screw for fixation.
Results: All patients were followed up for 6 to 32 months(means 19 months). The time of union of fracture was about 3 to 5 months. The outcome was evaluated according to Baired-Jackson criteria,the results were excellent in 27 cases,good in 7,fair in 5,poor in 1. Seven cases were found the operative incision and wound surface difficult to heal,among them 5 cases came from the emergency operation patients,1 case was closed fracture patient. They were be healed by change of dressing or dermatoplasty or skin flap.
Conclusion: It is the key factor of treatment for Pilon fractures to correct evaluate before operation and select correct operation time. It is also important to selected suitable internal fixation and good reduction. |
| KEYWORDS:Pilon fractures Fracture fixation,internal Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李雄峰,蒋雪生,管国华,黄胜,吴猛.Pilon骨折手术治疗和内固定选择[J].中国骨伤,2009,22(8):621~623 |
| 英文格式: | LI Xiong-feng,JIANG Xue-sheng,GUAN Guo-hua,HUANG Sheng,WU Meng.Surgical treatment and the fixator selection for Pilon fractures[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(8):621~623 |
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