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前外侧入路治疗RuediⅡ-Ⅲ型Pilon骨折
Hits: 2530   Download times: 1441   Received:September 25, 2010    
作者Author单位UnitE-Mail
陈勇 CHEN Yong 南京军区南京总医院骨科, 江苏 南京 210002 Department of Orthopaedics, the General Hospital of NanJing Military Commond of PLA, Nanjing 210002, Jiangsu, China chenyoong@sina.com 
孙国静 SUN Guo-jing 南京军区南京总医院骨科, 江苏 南京 210002 Department of Orthopaedics, the General Hospital of NanJing Military Commond of PLA, Nanjing 210002, Jiangsu, China  
任可 REN Ke 南京军区南京总医院骨科, 江苏 南京 210002 Department of Orthopaedics, the General Hospital of NanJing Military Commond of PLA, Nanjing 210002, Jiangsu, China  
方益春 FANG Yi-chun 南京军区南京总医院骨科, 江苏 南京 210002 Department of Orthopaedics, the General Hospital of NanJing Military Commond of PLA, Nanjing 210002, Jiangsu, China  
李桂军 LI Gui-jun 南京军区南京总医院骨科, 江苏 南京 210002 Department of Orthopaedics, the General Hospital of NanJing Military Commond of PLA, Nanjing 210002, Jiangsu, China  
赵建宁 ZHAO Jian-ning 南京军区南京总医院骨科, 江苏 南京 210002 Department of Orthopaedics, the General Hospital of NanJing Military Commond of PLA, Nanjing 210002, Jiangsu, China  
期刊信息:《中国骨伤》2011年24卷,第4期,第342-344页
DOI:10.3969/j.issn.1003-0034.2011.04.022


目的:探讨前外侧入路治疗严重Pilon骨折的疗效。

方法:2002年 2月至 2008年3月, 采用前外侧入路治疗的 RuediⅡ-Ⅲ型 Pilon骨折63例, 男36例, 女27例;年龄19~71岁, 平均37岁。受伤至治疗时间为2 h~19 d, 平均8 d.按Ruedi分型:Ⅱ型32例(合并局部软组织挫裂伤6例, 其中4例为开放骨折), Ⅲ型31例(合并局部软组织挫裂伤9例, 其中8例为开放骨折).术后观察创面愈合情况、骨感染、骨不连、骨折畸形、踝关节活动度及疼痛程度, 评价手术疗效。

结果:4例患者创面不愈合, 经过植皮或皮瓣覆盖创面愈合, 5例因骨不连超关节固定时间长, 导致踝僵硬活动受限。所有患者获得随访, 时间8~31个月, 平均15.3个月。骨愈合时间8~14周, 平均10周。按Helfet疗效评价标准:优28例, 良30例, 差5例。

结论:采用前外侧入路治疗RuediⅡ-Ⅲ型Pilon骨折能取得满意的治疗效果, 可有效避免并发症的发生。
[关键词]:Pilon骨折  骨折固定术  并发症
 
The operative treatment of Ruedi Ⅱ-Ⅲ Pilon fractures with the ventr-lateral approach
Abstract:

Objective: To investigate the effects of the ventr-lateral approach in treating severe Pilon fracture.

Methods: From February 2002 to March 2008, 63 patients with RuediⅡ-ⅢPilon fractures were treated with the the ventr-lateral approach, including 36 males and 27 females with an average age of 37 years ranging from 19 to 71 years. The mean time from injury to operation was 8 days (ranged for 2 h-19 d). According to the Ruedi classification system, typeⅡwas 32 cases (6 cases of them combined with soft tissue lesion, 4 with open fracture) and typeⅢwas 31 cases (9 cases of them combined with soft tissue lesion, 8 with open fracture). The clinical effects were evaluated according to Helfet criteria and the complications were observed including condition of wound healing, infection, bone union, deformity union, motion of the ankle, the degree of the pain and so on.

Results: The first intention achieved in 59 cases, the delayed healing in 4 cases. Stiffness of the ankle was found in 5 cases because of bone disunion. All patients were followed up from 8 to 31 months with an average of 15.3 months. The ranging in bone healing time was from 8 to14 weeks with an average of 10 weeks. According to the Helfet criteria, 28 cases obtained excellent results, 30 good, 5 poor.

Conclusion: The operative treatment of RuediⅡ-ⅢPilon fractures with the ventr-lateral approach can obtain satisfactory results and avoid complications effectively.
KEYWORDS:Pilon fracture  Fracture fixation  Complications
 
引用本文,请按以下格式著录参考文献:
中文格式:陈勇,孙国静,任可,方益春,李桂军,赵建宁.前外侧入路治疗RuediⅡ-Ⅲ型Pilon骨折[J].中国骨伤,2011,24(4):342~344
英文格式:CHEN Yong,SUN Guo-jing,REN Ke,FANG Yi-chun,LI Gui-jun,ZHAO Jian-ning.The operative treatment of Ruedi Ⅱ-Ⅲ Pilon fractures with the ventr-lateral approach[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(4):342~344
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