凌广烽等

[摘要] 目的 探讨分析锁定钢板有限固定治疗Pilon骨折的临床效果。方法 选取2011年5月—2012年10月来该院就诊治疗的胫骨Pilon骨折患者98例，对此98例患者均采用锁定钢板有限固定的治疗方法，观察统计患者的骨折愈合时间同时在患者出院8个月后进行Mazur评分，了解患者的治疗优良率及术后并发症发生率情况。结果 所有98例患者骨折愈合时间13～27周，平均17.6周，随访所有患者8个月，根据Mazur评分系统得知患者治疗优良率为88.8%，术后出现创伤性关节炎等不良反应共7例，不良反应发生率为7.1%。结论 锁定钢板有限固定治疗胫骨PIlon骨折具有较好的临床效果，术中注意保留软组织及稳定关节面可尽量减少患者术后发生不良反应，较为安全，值得临床推广应用。

[关键词] 锁定钢板；有限固定；Pilon骨折；临床

[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742（2014）02（a）-0020-02

[Abstract] Objective To observe the clinical effect of locking plate limited fixation in the treatment of Pilon fracture. Methods From May， 2011 to October， 2012， 98 patients with tibial Pilon fractures admitted in our hospital were selected. And they were treated with locking plate fixed limitation. The time of fracture healing of the patients were observed and counted. And the patients were evaluated by Mazur score after they were discharged 8 months so as to understand the excellent and good rate of treatment and the incidence of complications postoperative. Results The fracture healing time of the 98 patients was 13-27 weeks， with an average of 17.6 weeks. All the patients were followed up for 8 months， and the excellent and good rate of treatment of the patients was 88.8%，according to Mazur scoring system. Postoperative adverse reactions such as traumatic arthritis occurred in 7 cases， and the incidence of adverse reactions was 7.1%. Conclusion Locking plate limited fixation in the treatment of tibial Pilon fractures have better clinical results， intraoperative paying attention to preserve the soft tissue and stable joint surface can minimize the incidence of postoperative adverse reactions， which is more secure and worthy of clinical application.

[Key words] Locking plate； Limited fixation； Pilon fractures； Clinical

胫骨Pilon是指踝关节及胫骨远端的干骺端骨折，往往涉及了下肢的负重关节面，是临床上以后总较难治疗的关节内骨折[1]。有研究[2]显示，胫骨Pilon骨折约占胫骨骨折的7%～10%，临床上并不少见。有学者[3]指出，胫骨Pilon骨折由于常存在干骺端的压缩现象，患者预后多半较差。为探讨研究锁定钢板有限固定治疗Pilon骨折的临床的效果，改善该类患者的预后提供一种有效可靠的治疗方法，选取2011年5月—2012年10月期间的98例胫骨Pilon骨折患者为研究对象，现报道如下。

1 资料与方法

1.1 一般资料

选取来该院就诊治疗的胫骨Pilon骨折患者98例，其中男62例，女36例，年龄20～72岁，平均年龄（38.7±5.4）岁；左侧42例，右侧56例，开放性损伤27例，闭合性损伤71例；……