[1]李宇 黄涛 葛俊波 洪焕玉 张海光.胫骨远端前外侧锁定钢板延期治疗复杂Pilon骨折[J].中国中医骨伤科杂志,2013,21(06):30-31.
　LI Yu HUANG Tao GE Junbo HONG Huanyu ZHANG Haiguang.LCP Anterolateral Distal Tibia Plate for Treatment of ComplexPilon Fractures at a Delayed-stage[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2013,21(06):30-31.
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胫骨远端前外侧锁定钢板延期治疗复杂Pilon骨折
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第21卷
期数:
2013年06期
页码:
30-31
栏目:
临床研究
出版日期:
2013-06-03

文章信息/Info

Title:
LCP Anterolateral Distal Tibia Plate for Treatment of Complex Pilon Fractures at a Delayed-stage
作者:
李宇1 黄涛1 葛俊波1 洪焕玉1 张海光1
1烟台山医院骨创伤四科(山东 烟台,264000)
Author(s):
LI Yu1 HUANG Tao1 GE Junbo1 HONG Huanyu1 ZHANG Haiguang1
1Department of 4th Ward of Bone Trauma Orthopedics, Yantaishan Hospital, Yantai 264000, Shandong, China
关键词:
Pilon骨折;  骨移植;  前外侧;  锁定钢板
Keywords:
Pilon fractures;  Bone grafting;  Anterolateral;  Locking compression plate
摘要:
目的:探讨延期切开复位结合胫骨远端前外侧“L”形锁定钢板治疗复杂Pilon骨折。方法:30例Pilon骨折患者,按AO分类方式,所有患者均为C型:C1型7例,C2型15例,C3型8例。6例为开放性骨折,24例为闭合性骨折,延迟手术时间为7～14d(平均10.5d),待肿胀消退后行切开复位结合胫骨远端前外侧“L”形锁定钢板内固定治疗。结果:30例均获术后随访,随访时间14～28个月(平均18.5个月)。骨折临床愈合时间为12～23个月(平均14.3个月)。术后有2例伤口感染; 3例皮肤坏死; 5例出现骨折延迟愈合,其中2例再次行植骨手术; 1例过早负重,导致骨折端畸形愈合。临床疗效根据AOFAS评分系统进行评定:优 18例,良 9,可 3例,优良率为90%。结论:严重Pilon骨折根据不同的骨折类型、软组织损伤程度选择不同的手术方式和手术时机非常重要。延期切开复位结合胫骨远端前外侧“L”形锁定钢板是临床治疗复杂Pilon骨折的理想方法。
Abstract:
To detect the curative effect of delayed open reduction and "L"-shaped LCP anterolateral distal tibia plate for treating of complex Pilon fractures. Methods:A total of 30 cases of Pilon fractures were treated by open reduction and "L"-shaped LCP anterolateral distal tibia plate after improvement of soft tissue conditions. All the cases were type C fracture according to AO classification, 7 cases of which were type C1, 15 cases were type C2, and 8 cases were type C3. There were 6 cases of open Pilon fractures and 24 cases of closed fractures. Operations were performed on average 10.5 days after the injuries(range 7 to 14 days). Results:All the patients were followed-up for 14 months to 28 months(18.5 months averagely).The average healing times was 12 to 23 months(14.3 months averagely). There were 2 cases of wound infection, 3 cases of cutaneous necrosis, and 5 cases of delayed bone healing, including two cases of bone grafting surgery again. There was also one case of malunion due to early weight-bearing. According to score system of American Foot and Ankle Society(AOFAS), there were 18 cases in excellent, 9 cases in good, and 3 cases in fair. The rate of excellent and good was 90%. Conclusion:It is important to select the right surgical method and time for treating patients of severe Pilon fractures depending on type of fractures and degree of soft tissue injury. Extended open reduction combined with "L"-shaped LCP anterolateral distal tibia plate is ideal method in treatment of complex Pilon fractures.

参考文献/References:

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更新日期/Last Update: 2013-06-03