UNILATERAL EXTERNAL FIXATION FOR SEVERE PILON FRACTURES
UNILATERAL EXTERNAL FIXATION FOR SEVERE PILON FRACTURES
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DOI：
10.1177/107110079301400201
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发表时间：
1993-02-01
期刊：
影响因子：
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通讯作者：
MARSH, JL
中科院分区：
文献类型：
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作者：
BONAR, SK;MARSH, JL
采用单侧大螺钉外固定治疗21例严重胫骨平台骨折。在 15 名患者中，结合了有限的内固定。根据 Ovadia 和 Beals 的方法对骨折进行分类。12 其中 III 型骨折 9 例，IV 型骨折 4 例，V 型骨折 8 例；根据 Ruedi 和 Allgower 的方法，II 型骨折 9 例，III 型骨折 12 例。七处骨折是开放性的。五处骨折由于严重粉碎而没有尝试进行关节重建。其中 4 例骨折需要踝关节融合术，1 例 IIIB 型骨折需要晚期截肢。所有其他骨折均已愈合。无伤口感染、皮肤腐肉或骨髓炎病例。距骨和跟骨的大螺钉外固定与明显的早期或晚期并发症无关。在容易发生伤口并发症的区域，较少广泛的组织解剖可能是感染、伤口并发症和骨不连发生率较低的原因。
Twenty-one patients with severe tibial plafond fractures were treated by unilateral large screw external fixation. In 15 patients, this was combined with limited internal fixation. The fractures were classified according to the methods of Ovadia and Beals.12 There were nine type III, four type IV, and eight type V fractures, and according to the methods of Ruedi and Allgower, nine type II and 12 type III fractures. Seven fractures were open.In five fractures, no attempt was made at articular reconstruction due to severe comminution. Four of these fractures required ankle arthrodeses and one type IIIB fracture received a late amputation. All other fractures healed. There were no cases of wound infection, skin slough, or osteomyelitis. Large screw external fixation in the talus and calcaneus was not associated with significant early or late complications. The less extensive tissue dissection in an area prone to wound complications may account for the low rates of infections, wound complications, and nonunion.