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中国现代手术学杂志  2018, Vol. 22 Issue (4): 281-284    DOI: 10.16260/j.cnki.1009-2188.2018.04.011
  临床论著 |
T型钢板在胫骨后pilon骨折中的应用#br#
王振,刘青,郑福增,李西要,曲波,董黎明
河南省洛阳正骨医院(河南省骨科医院),洛阳 471002
The Application of Tplates in the Posterior Pilon Fractures of Tibia#br#
WANG Zhen, LIU Qing, ZHENG Fuzeng, LI Xiyao, QU Bo, DONG Liming#br#
Department of Orthopedics, Luoyang Orthopedictraumatological Hospital (Luoyang Orthopedic Hospital), Luoyang 471002, Henan, China
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摘要 [摘要]目的总结评估T型钢板在胫骨后pilon骨折的应用效果。方法回顾性分析我院2013年12月至2015年6月足踝科收治的26例胫骨后pilon骨折患者的临床资料,其中男 20例,女6 例;年龄 26~62岁,平均 34.2 岁,胫骨后侧骨块选用T型钢板固定,患者术前均行X线及CT扫描,根据俞光荣等对胫骨后pilon骨折的分型标准,采用后外侧或后内侧联合入路复位固定骨折,术后通过临床检查及X线片随访,采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society, AOFAS)踝-后足评分进行评估。结果术后踝关节功能根据AOFAS评分,优8例,良14例,中4例,优良率为84.6%。2例患者术后出现胫后神经症状,术后3月症状消失,1例出现外踝近端伤口液化;1例患者在术后CT矢状位片上发现胫骨后内侧关节面向近端移位(<1.5 mm),其余患者功能恢复好,骨折对位对线好,踝关节匹配好。结论T型钢板在胫骨后pilon骨折治疗中,可以恰当支撑后内或后外侧关节面,固定效果牢靠,值得临床推广应用。

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王振
刘青
郑福增
李西要
曲波
董黎明
关键词:  [关键词] 踝损伤  胫骨骨折  后pilon  骨折固定术 
    
Abstract: Abstract:ObjectiveTo review and evaluate the application of Tplates in the posterior pilon fractures of tibia.Methods26 cases with the posterior pilon fractures of tibia were treated from December 2013 to June 2015 in our hospital. There were 20 cases of male and 6 of female, aged from 26 to 62 years, with an average of 34.2 years. The posterior tibial fractures were planned to be fixed with Tplates. Xray and CT scan were performed before the operation. According to YU Guangrong's classification criteria for the posterior pilon fractures of the tibia, the posterolateral approach or posterior medial combined approach was used to fix the fracture. After surgery, the clinical examination and Xray followup were used to evaluate the bone curing efficacy of the fixation. Ankle hindfoot scale of American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the ankle function.ResultsAccording to the AOFAS, there were 8 cases of excellent, 14 of good, and 4 of middle. The good rate was 84.6%. After the operation, the symptoms of the posterior tibial nerve were found in 2 patients, which disappeared in 3 months. There were 1 case of wound liquefaction and 1 case of a 1.5 mm stepping upward on the sagittal plane of CT. The rest of the patients recovered well with good alignment and good ankle joints.ConclusionTplates can effectively support the posterior or posterolateral articular surfaces in the treatment of posterior tibial pilon fractures. The fixation effect is reliable, and the method is worthy of clinical application.

Key words:       ankle injuries    tibial fractures    posterior pilon    fracture fixation, internal
               出版日期:  2018-08-26      发布日期:  2018-10-23      期的出版日期:  2018-08-26
ZTFLH:     
  R683.4  
通讯作者:  刘青,女,32岁,河南省洛阳正骨医院(河南省骨科医院)主治医师。    
引用本文:    
王振, 刘青, 郑福增, 李西要, 曲波, 董黎明. T型钢板在胫骨后pilon骨折中的应用#br#[J]. 中国现代手术学杂志, 2018, 22(4): 281-284.
WANG Zhen, LIU Qing, ZHENG Fuzeng, LI Xiyao, QU Bo, DONG Liming. The Application of Tplates in the Posterior Pilon Fractures of Tibia#br#. Chinese Journal of Modern Operative Surgery, 2018, 22(4): 281-284.
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http://www.surgerychina.com/CN/10.16260/j.cnki.1009-2188.2018.04.011  或          http://www.surgerychina.com/CN/Y2018/V22/I4/281
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