| 经改良后内侧入路支撑钢板内固定治疗后Pilon骨折 |
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Received:August 18, 2017
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| 作者 | Author | 单位 | Unit | E-Mail |
| 解冰 |
XIE Bing |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 田竞 |
TIAN Jing |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 周大鹏 |
ZHOU Da-peng |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
me3210@163.com |
| 薛海鹏 |
XUE Hai-peng |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 杨超 |
YANG Chao |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 张昊 |
ZHANG Hao |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 田帅 |
TIAN Shuai |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 王源伟 |
WANG Yuan-wei |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 胡汉 |
HU Han |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 期刊信息：《中国骨伤》2018年31卷，第7期，第656-660页 |
| DOI：10.3969/j.issn.1003-0034.2018.07.013 |
| 基金项目:2014年全军后勤重大项目（编号：AWS14C003） |
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目的:探讨采用改良后内侧入路支撑钢板固定治疗后Pilon骨折的临床疗效。
方法：自2014年7月至2015年1月手术治疗10例后Pilon骨折患者，其中男3例，女7例，年龄31~54岁。根据俞光荣等提出的后Pilon骨折分型，Ⅰ型1例，Ⅱ型3例，Ⅲ型6例。所有患者采用改良后内侧入路支撑钢板内固定治疗。记录患者术后并发症、骨愈合及复位情况，并予术后1年采用美国足踝外科协会（American Orthopedic Foot and Ankle Society，AOFAS）踝与后足功能评分评价临床疗效。
结果：10例患者均获随访，时间12~18（14.1±3.2）个月。患者术后切口均Ⅰ期愈合，无切口感染、血管神经损伤及屈肌腱挛缩发生。术后根据Burwell-Charnley影像学评价标准判定骨折复位，后踝解剖复位8例，复位良好2例。所有骨折均获得愈合，时间12~16（13.2±1.8）周。术后1年根据AOFAS评分评定临床疗效，优8例，良2例。患者术后3~6（4.7±1.4）个月重返原工作岗位。
结论：改良后内侧入路支撑钢板固定治疗后Pilon骨折临床疗效肯定，并发症少，患者可以早期负重功能锻炼。 |
| [关键词]:胫骨骨折 骨折内固定术,内 外科手术 |
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| Clinical outcomes of buttress plating in treating posterior Pilon fractures through modified posteromedial approach |
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Abstract:
Objective: To explore clinical outcomes of buttress plating in treating posterior Pilon fracture by amodified posteromedial approach.
Methods: From July 2014 to January 2015,10 patients with posterior Pilon fracture were respectively analyzed,including 7 females and 3 males,aged from 31 to 54 years old. One patient were typeⅠ,3 patients were typeⅡand 6 patients were type Ⅲ according to classification of Pilon fracture by YU Guang-rong. All patients were treated by buttress plating through amodified posteromedial approach. Postoperative complications,fracture healing and reduction were observed,AOFAS score were used to evaluate function recovery at 1 year after operation.
Results: All patients were followed up for 12 to 18 months with an average of(14.1±3.2) months. All incisions were primarily healed at stageⅠwithout wound complication,neurovascular injuries or musculus flexor contracture. According to Burwell-Charnley imaging scoring,8 patients got anatomical reduction and 2 patients got moderate reduction. All fracture got healing from 12 to 16 weeks with an average of(13.2±1.8) weeks. According to AOFAS score at 1 year after operation,8 got excellent results and 2 moderate. All patients returned to work at about(4.7±1.4) months (ranged from 3 to 6 months) after operation.
Conclusion: Buttress plating using a modified posteromedial approach in treating posterior Pilon fractures is an effective method,has less complications,and could recovery early weight-bearing functional exercise. |
| KEYWORDS:Tibial fractures Fracture fixation,internal Surgical procedure,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: | 解冰,田竞,周大鹏,薛海鹏,杨超,张昊,田帅,王源伟,胡汉.经改良后内侧入路支撑钢板内固定治疗后Pilon骨折[J].中国骨伤,2018,31(7):656~660 |
| 英文格式: | XIE Bing,TIAN Jing,ZHOU Da-peng,XUE Hai-peng,YANG Chao,ZHANG Hao,TIAN Shuai,WANG Yuan-wei,HU Han.Clinical outcomes of buttress plating in treating posterior Pilon fractures through modified posteromedial approach[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(7):656~660 |
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