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目的探讨有限内固定结合外固定支架辅助中药疗法治疗Pilon骨折的临床价值。方法我院自2003年6月至2010年1月采取有限内固定结合外固定支架辅助中药疗法治疗Pilon骨折18例1,5例合并腓骨远端骨折。均采用腓骨嵴后侧切口,胫骨前内侧小切口,腓骨采用重建钢板固定,胫骨远端采取有限内固定结合外固定支架固定。术后以骨折不同阶段行辨证行中药辅助治疗。结果 18例患者均获得随访,随访时间16～36个月。按照Mazur等制定踝关节的评分标准:优10例,良6例,差2例;1例出现针道感染,4例出现创伤性骨关节炎。无骨折不愈合或畸形愈合,无肢体短缩,无血管神经损伤。结论采用有限内固定结合外固定支架并辅助中医疗法治疗Pilon骨折能有效地减少并发症,恢复良好的踝关节功能,该方法操作简便、创伤小、复位满意、固定可靠、不影响关节功能康复,是治疗Pilon骨折较理想的方法。
Objective To investigate the clinical value of limited internal fixation combined with external fixation with traditional Chinese medicine in the treatment of Pilon’s fracture. Methods A total of 18 cases of Pilon fracture and 1 case of distal fibula fracture were treated with limited internal fixation and external fixator in our hospital from June 2003 to January 2010. Both posterior fibular crest incision, anterior medial small incision, the fibula was reconstructed plate fixation, distal tibial finite external fixation with external fixation. Postoperative fractures in different stages of line TCM traditional Chinese medicine adjuvant therapy. Results 18 patients were followed up for 16 to 36 months. According to Mazur and other ankle rating criteria: excellent in 10 cases, good in 6 cases, poor in 2 cases; 1 case of needle infection, 4 cases of traumatic osteoarthritis. No fracture nonunion or malunion, no limb shortening, no vascular nerve injury. Conclusion The limited internal fixation combined with external fixator and traditional Chinese medicine treatment of Pilon fractures can effectively reduce complications and restore good ankle function. The method is simple and easy to operate, less trauma, satisfactory reduction and reliable fixation without affecting the rehabilitation of joint function. Is the ideal method of treatment of Pilon fractures.