骨缝合结合锁定钢板内固定治疗合并腓骨骨折的C型Pilon骨折

Treatment of Type C Pilon Fractures with Fibula Fracture by Bone Suture Combined with Locking Plate Internal Fixation

摘要: 目的：探讨经双切口采用骨缝合技术结合锁定钢板内固定治疗合并腓骨骨折的C型Pilon骨折的临床疗效。方法：回顾分析2018年01月至2022年01月我科运用骨缝合技术结合锁定钢板内固定治疗的13例合并腓骨骨折的C型Pilon骨折患者临床资料，其中男性患者8例，女性5例，平均年龄44.5岁。本组患者采用对部分破碎游离骨块进行骨缝合结合锁定钢板内固定治疗，术后定期复查并按医务人员指导进行功能锻炼，对患者治疗终末时骨折愈合及踝关节功能恢复情况进行分析。结果：13例患者骨折均实现临床愈合，愈合时间平均为6.54 ± 1.36月。1例患者出现创口局部坏死，部分钢板外露，经治疗后创口愈合，其余患者未出现皮肤坏死、骨折移位、严重感染、骨折不愈合并发症发生。治疗终末患者踝关节功能评定优6例，良6例，优良率92.31%。结论：经双切口采用骨缝合结合锁定钢板内固定治疗合并腓骨骨折的C型Pilon骨折，可简化手术过程，提高复位质量，可获得较好的治疗效果。

Abstract: Objective: This paper aims to investigate the clinical effect by bone suture combined with locking plate internal fixation in the treatment of type C Pilon fracture complicated with fibula fracture. Methods: From January 2018 to January 2022, 13 patients (8 males, 5 females; mean age 44.5 years) with type C Pilon fracture complicated with fibula fracture treated by bone suture combined with locking plate internal fixation were retrospectively analyzed. Regular follow-up examinations and functional exercises were performed after surgery. The recovery of ankle joint function and fracture healing time were analyzed. Results: The mean time to fracture healing was 6.54 ± 1.36 months. One patient had skin necrosis and part of the plate was exposed, and the wound healed after careful treatment finally. The other patients did not have serious soft tissue infection, fracture displacement, osteomyelitis, fracture nonunion, or other complications. At the end of treatment, functional outcomes were excellent in 6, and good in 6. The excellent and good rate of functional results was 92.31%. Conclusion: Bone suture combined with locking plate internal fixation is a simple and effective method for the treatment of type C Pilon fracture with fibula fracture, and it could obtain better therapeutic effect.