标题：两种不同术式治疗Pilon骨折的疗效比较分析

      作者：王佳斌，艾江平，占紫龙
    (三亚市人民医院骨科，海南 三亚 572000)

      卷次： 2012年23卷8期

      【摘要】 目的 探讨两种手术方式对Pilon骨折复位的效果及并发症的影响。方法 选择77例Pilon骨折
患者，分别采用两种手术方法进行治疗，其中采用分步延期ORIF法 39例和有限内固定结合外固定支架法 38
例。术后采用Burwell-Charnley评价标准进行放射学的评价和Olerud-Molander评分标准进行临床疗效的评价，
同时对并发症进行观察。结果 在并发症方面，在术后8个月时，采用分步延期ORIF法的患者中，出现3例并发
症；而采用有限内固定结合外固定支架法的患者中，出现9例并发症，两组比较差异有统计学意义(P<0.05)。在放
射学评价方面，在术后8个月时，分步延期ORIF法中达到解剖复位为17例，功能复位18例，复位差3例；有限内
固定结合外固定支架法达到解剖复位10例，功能复位16例，复位差9例，两组比较差异有统计学意义(P<0.05)。
在临床疗效方面，分步延期ORIF法在上台阶、跑步、跳跃和支撑方面与B法比较，差异有统计学意义(P<0.05)。
结论 采用分步延期ORIF法治疗Ⅱ、Ⅲ型Pilon骨折，能有效维持解剖复位，减少术后并发症，并能达到较好的
临床效果，值得推荐。

      【关键词】 Pilon骨折；分步延期ORIF法；有限内固定结合外固定支架法；效果；并发症

      【中图分类号】 R683.42 【文献标识码】 A 【文章编号】 1003—6350(2012)08—035—04<

br>Comparison of two surgical methods in the treatment of Pilon fracture.
WANG Jia-bin, AI Jiang-ping, ZHAN
Zhi-long. Department of Orthopedics, People's Hospital of Sanya City, Sanya 572000, Hainan, CHINA

【Abstract】 Objective To evaluate the influence of two surgical methods on the reduction effects and compli-
cations of Pilon fracture. Methods Seventy-seven patients with Pilon fracture were selected and divided into two
groups. Patients in group A (n=39) underwent delay open reduction and internal fixation, while those in group B (n=
38) were treated with limited internal fixation and external fixator. All the patients were followed up, and evaluated
with the criteria of Burwell-Charnley and the criteria of Olerud-Molander. The complication was observed. Results
Eight months of surgery, two patients in group A and 9 patients in group B had complications after, showing statistical-
ly significant difference between two group (P>0.05). In the criteria of Burwell-Charnley, group A was significantly
better than group B (P<0.05). In the criteria of Olerud-Molander, group A was significantly better than group B in run-
ning, jumping and support and taking step (P<0.05). Conclusion For treating typeⅡ andⅢ fracture, delay open re-
duction and internal fixation can maintain anatomical reduction and reduce postoperative complications, which can
achieve better clinical results and should be recommended.

      【Key words】 Pilon fracture; Delay open reduction and internal fixation; Limited internal fixation and external
fixator; Efficacy; Complication