- 期刊
Surgical Treatment for Pilon Fracture of the Ankle-Open Reduction and Internal Fixation
遠端脛骨併踝關節骨折之手術治療一觀血復位及內固定術
摘要
從1991到1994，有38個患者之39例遠端腔骨併踝關節骨折，包括29位男性、9位女性，平均年齡為38.6 歲（28歲一58歲），接受開刀復位手術，這些病人接受了平均31.7個月的追蹤（22個月一44個月），檢查的項目包含站立的X 光來確定關節炎的情形，及臨床功能的分數評估。併發症包括有一例感染，二例部分皮膚壞死，有二例延遲癒合。有23 例發生創傷後關節炎（佔59 % ）但僅有4 例第四級的關節炎病人為差的功能分數，而總滿意度為82％。 完全復位，牢靠的固定，和早日運動是腳踝骨折要有良好結果的必要條件，而在Piton fracture 其骨折的嚴重度和延遲的復位都是影響結果的因素。適當的開刀術野以看到整個踝關節面，腓骨的固定，足夠的骨頭移植以支持關節面，術中X 光的確定，術後一段時間的固定都是對要有良好臨床結果所需要的。
關鍵字
無資料並列摘要
From 1991 to 1994, 39 ankles of 38 patients underwent surgical open reduction and internal fixation for pilon fractures. These patients included 29 males and 9 females with an average age of 38.6 y/o (range 28 y/o-58 y/o). The follow up and evaluation period averaged 31.7 months (range 22Ms-44Ms), during which time a standing x-ray for arthrosls grading and functional scale was used for clinical evalution. Complications included 1 case of infectIon, 1 case of loss reduction, 2 cases of partial skin necrosis and 2 cases of delayed union. Post-traumatic arthritis occurred In 23 ankles (59%) but only 4 ankles of grade 4 arthrosis resulted In poor functional scale and the overall satisfactory rate was 82%. It was found that anatomic reduction, rigid fixation and early motion exercise are important to successful treatment of ankle fractures. Regarding pilon fracture, specifically the severity of fracture pattern and delay of reduction are important problems to overcome to ensure successful results. Therefore, adequate surgical approach for entire view of ankle joint, reduction and fixation of fibula, sufficient bone graft for articular support, intraoperatlve x-ray check and postoperative immobilization are essential for the achievement of better clinical results.