Pilon骨折术前跟骨牵引与手术治疗

Calcanceal traction and surgical treatment before operation of Pilon fractures

摘要: 目的: 探讨Pilon骨折术前跟骨牵引的重要性及Pilon骨折的治疗方法的适应证。方法: 治疗32例34肢,Pilon骨折Ⅰ型6例,Ⅱ型21例,Ⅲ型5例。采用闭合复位石膏外固定6例,跟骨牵引辅以小夹板外固定4例,胫骨远端解剖钢板17例,有限手术切开螺钉内固定单臂外固定支架固定5例,有2例采用自体髂骨植骨,3例采用人工骨植骨。结果: 随访4个月~3.5年,优良23例,可5例,差4例。结论: 根据Pilon骨折的不同分型,采用合适的治疗方法。

Abstract: Objective: To investigate the importance of calcanceal traction before operation of Pilon fracture and its indications.Methods: Thirty-two cases(34 limbs) of Pilon fracture were treated.According to Rüedi-Allgower classification,6 cases were classified as typeⅠ,21 cases typeⅡ,and 5 cases typeⅢ.Six cases were treated with anipalative reduction and external fixation by cast,4 cases with calcanceal traction and spliats fixation,17 cases with anatominal plate of distal tibia and 5 cases with limited open reduction and internal screw fixation combined with unilateral external fixation.Two cases received auto-ilium transplant and 3 cases artificial bone transplant.Results: All the cases were followed up for 4 months to 3.5 years.The results were excellent in 23 cases,good in 5 and poor in 4.Conclusions: proper measures should be taken according to the types of Pilon fracture.