目的 探讨C形臂X线机辅助下L形解剖锁定钢板微创治疗Rüedi-AllgöwerⅡ、Ⅲ型闭合性Pilon骨折的临床疗效。方法 在2013-01至2018-12武警第二机动总队医院采用术中分次C形臂X线机透视骨折部位,有限切开组织,骨折复位满意,L形锁定钢板固定良好,微创治疗Rüedi-AllgöwerⅡ、Ⅲ型闭合性Pilon骨折24例患者。结果 24例均获得随访,时间6～24个月,平均(15±3.25)个月,骨折愈合佳,无切口感染、血管损伤及踝关节僵硬等并发症;仅有1例出现创伤性关节炎,后经康复治疗1年后恢复正常。根据Mazur踝关节功能评分以及骨折的复位愈合程度评定:优16例,良5例,可3例,优良率为87.5%。结论 C形臂X线机辅助下L形锁定钢板微创治疗Rüedi-AllgöwerⅡ、Ⅲ型闭合性Pilon骨折,临床观察,疗效满意。

Objective To investigate the clinical effect of C-arm X-ray machine assisted minimally invasive treatment of 24 cases of Rüedi-AllgöwerⅡ, Ⅲ closed Pilon fractures withL-shaped anatomical locking plates.Methods C-arm X-ray machine was used to fluoroscope the fractures.Patients whose incision of tissuewas limited and fracture reduction was satisfactory were selected. L-shaped anatomical locking plateswere fixed well in these patients between January 2013 and December 2018.Results All the cases were followed up for 6 to 24 months, with anaverage of(15±3.25) months. The fracture healing of the patients was good. There were no such complications as wound infection, vascular injury or ankle stiffness. Only one patient developed traumatic arthritis, which returned to normalafter a year of rehabilitation. According to Mazur ankle function score and fracture reduction and healing degree evaluation, 16 patients were rated as excellent, 5 as good, and 3 as fair. The rate of excellent and good effect was 87.5%.Conclusions The curative effect of minimally invasive treatment of Rüedi-Allgöwer Ⅱ, Ⅲclosed Pilon fracture with L-shaped anatomical locking plates assisted by C-arm X-ray machine is satisfactory.