标题：前外侧单切口结合“L”型锁定钢板治疗Pilon骨折30例

      作者：王本海，林松庆，陈金水，黄伟    联勤保障部队第九OO医院骨一科，福建 福州 350025

      卷次： 2019年30卷13期

      【摘要】 目的 探讨小腿前外侧单切口结合胫骨远端前外侧“L”型锁定钢板治疗 Pilon骨折的临床疗效。方法 回顾性分析 2010年 9月至 2017年 12月在联勤保障部队第九OO医院骨一科手术治疗并获得随访的 30例Pilon骨折患者的临床资料，30例患者中交通事故伤17例，高处坠落伤9例，重物砸伤4例。开放性骨折6例，闭合性骨折24例。骨折按Ruedi-Allgower分类方法：Ⅱ型25例；Ⅲ型5例。结果 术后平均随访6~12个月；按Mazur评分系统，随访的30例患者中优23例，良5例，优良率为93.3%；2例术后出现切口感染，皮肤部分坏死，骨钢板外露，均在术后2周左右行穿支蒂隐神经营养血管皮瓣转移术，术后皮瓣成活。结论 采用前外侧单切口结合胫骨远端“L”型锁定钢板治疗Pilon骨折可获得良好的显露，满意的复位，坚强的固定，并且避免在小腿前内侧的皮肤作切口，为可能的二期皮瓣移植保存供区，取得优良的治疗效果。
      【关键词】 前外侧切口；Pilon骨折；骨折内固定；锁定钢板；单切口
      【中图分类号】 R683 【文献标识码】 A 【文章编号】 1003—6350（2019）13—1736—03

Treatment of 30 cases of Pilon fracture with anterolateral single incision combined with "L" type locking plate.WANG Ben-hai, LIN Song-qing, CHEN Jin-shui, HUANG Wei.
The First Department of Orthopaedics, the No.900 Hospitalof PLA Joint Logistic Support Force, Fuzhou 350025, Fujian, CHINA
【Abstract】 Objective To explore the clinical efficiency of anterolateral single incision combined with "L" typelocking plate in the treatment of Pilon fracture. Methods A retrospective analysis was performed on the clinical data of30 patients with Pilon fracture, who underwent surgical treatment in the First Department of Orthopaedic at the 900th Hos-pital of PLA Joint Logistic Support Force and were followed up from September 2010 to December 2017. Among the 30patients, 17 were injured for traffic accidents, 9 for high falls, and 4 for heavy objects. There were 6 open fractures and24 closed fractures. According to the Rüedi-Allg?wer classification, these fractures were classified in type Ⅱ(25 cases)and typeⅢ (5 cases). Results The average follow-up was 6 months to 12 months. According to the Mazur scoring sys-tem, 23 of the 30 patients who were followed up were excellent, and 5 of them were good; the excellent and good ratewas 93.3%. There were 2 patients who developed postoperative wound infections, partial skin necrosis, and bone plateexposure. They both were transferred with perforator pedicle saphenous neurovascular flap at about 2 weeks after sur-gery, and all flaps survived. Conclusion The use of the anterolateral single incision combined with "L" type lockingplate in the treatment of Pilon fracture can achieve good exposure, satisfactory reduction, strong fixation, and avoid askin incision in the anteromedial side of the lower leg, preserve the donor area for the possible second-stage skin flaptransplantation, and obtain excellent therapeutic effect.
      【Key words】 Anterolateral incision; Pilon fracture; Fracture internal fixation; Locking plate; Single incision·短篇论著·doi:10.3969/j.issn.1003-6350.2019.13.028基金项目：联勤保障部队第九OO医院院内课题(编号：2017L04)