Objective To investigate the curative effect of the multi-plate capture internal fixation for tibial Pilon fracture Methods In this study, 87 patients with tibial Pilon fracture were enrolled. According to Ruedi-Allgower classification, there were 11 cases of type Ⅰ,51 cases of type Ⅱ, and 25 cases of type Ⅲ Except 11 cases of type Ⅰ and 3 cases of type Ⅱ with serious skin contusion, the other 73 cases all used multi-plate capture internal fixation. The postoperative function of the ankle joint was evaluated using Mazur criteria Results All the cases were followed up for 6-16 months (average 766 months). The healing time was 12 to 19 week(average 14 weeks). The results were excellent in 51 cases, good in 17 cases and fair in 5 cases according to Mazur’s criteria The excellent and good rate was 93% There was no wound infection, delayed fracture healing or nonunion. The function of the ankle joint was good in each case Conclusions Treating Pilon fractrure with multi-plate fixation accords with AO fixation principle Because the plate is thin, it has strong plasticity . The thin screw has little impact on blood circulation of the fracture ends or on bone quality. The advantage of this method lies in simple operation, fixation reliability, early functional exercise, little trauma and few postoperative complicationsThe effect is satisfactory
Key words
multi-plate /
capture fixation /
tibial Pilon fracture
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Mazur J M , Schwartz E , Sheldon R S Ankle arthrodesis long-term fellow-up with gait analysis[J] J Bone Joint Surg (Am) , 1979, 61(7) : 964 -975
[2] Ruedi-Allower M Fractures of the lower end of the tibia into the ankle joint [J] Injury, 1969, 1: 92
[3] Blauth M, Bastian L, Krettek C, et al.Surgical options for the treatment of severe tibial pilon fractures: a study of three techniques [J] J Orthop Trauma, 2001, 15: 153-160
[4] Stannard J P, Robinson J T, Anderson E R, et al. Negative pressure wound therapy to treat hematomas and surgical incisions following high-energy trauma [J] J Trauma, 2006, 60: 1301-1306
[5] 张世民, 李海丰, 黄轶刚 骨折分类与功能评定[M]1版北京: 人民军医出版社, 2008: 271
[6] Strauss E J, Petrcelli G, Bong M, et al Blisters associated with lower-extremity fracture: results of a prospective treatment protocol [J] J Orthop Trauma, 2006, 20: 618-622
[7] Conroy J, Agarwal M, Giannoudis P V, et al Early internal fixation and soft tissue cover of severe open tibial pilon fractures [J] Int Orthop, 2003, 27: 343-347
[8] 凌义龙, 李志龙, 钱淼忠, 等 重建钢板治疗Pilon骨折[J] 中医正骨, 2005, 17(1):31
[9] 孙新宏, 秦玉东 急诊手术修复胫骨开放性Pilon骨折[J] 中国修复重建外科杂志,2005,19(6): 496
[10] 张伯锋, 李 衡, 李 增, 等 超踝关节可动外固定架治疗严重开放性Pilon骨折初步报告[J] 中华骨科杂志, 2003, 23(4) : 220
[11] 〖JP3〗Bhattacharyya T, Crichlow R, Gobezie R, et al Complications associated with the posterolateral approach for pilon fractures [J] J Orthop Trauma, 2006, 20: 104-107〖JP〗
[12] 〖JP4〗Howard J L, Agel J, Barei D P, et al A prospective study evaluating incision placement and wound healing for tibial plafond fractures [J] J Orthop Trauma, 2008, 22: 299-305