ABSTRACT
[Objective]To investigate the clinical effect of treatment of complex Pilon's fractures with limited internal fixations and external fixators.[Method]Since 2000,78 cases of complex Pilon's fractures with limited internal fixations and external fixators were treated,of which male 51cases,female 27cases,aged 20～79 years old,average 36 yrs.According to Ovadia and Beals classification,type Ⅲ 27 cases,type Ⅳ 35 cases,type Ⅴ 16 cases,fresh fracture 53cases,old fracture 25 cases,close fracture 57 cases,open fracture 21 cases.They were all treated by Kirsschner wires and screws together with external fixators.External fixator were removed at 1.5～2 months after operation and splints were used and began ankle movement.[Result]All cases were followed up after operation.The following observation time was 1～3 years,average 20 months.All fractures were ostcal concrescence.Two cases were evaginate about 5 degree.Three cases were open injury and needed flap grafting rehabilitation because skin and soft tissue were compressed severely and necrotized.Traumatic artharitis occurred in 4 cases,nitric oxide-releasing anti-inflammatory drug was needed.One case was treated with arthrodesis.The functional evaluation was completed according to standard of American Orthopedic Association of Foot and Ankle.The excellent rate was 87.2%.[Conclusion]Limited internal fixation and external fixator is one of the effective way of treatment of Pilon's fracture because it can immobilize the sections of fracture and avoid infection of soft tissue and nonunion of fracture.
ABSTRACT
[Objective]To summarize efficiency evaluation of treatment for tibial plateau fracture,to select optimal treatment for tibial plateau fracture in clinical practice.[Method]Retrospective analysis of 138 patients of tibial plateau fracture in our hospital from January 1999 to January 2003.They were all fresh fracture within 2 weeks after trauma,79 cases male 59 cases female,age 15~76,average 43.5 yrs.95 cases complicated with ligament and meniscus injure in knee joint.according to B 1,B2 were treat with manipulative reduction,traction AO classification and sinking degree,they were divided into type B and type C.type and external fixation of splint.Type B3,C1 were treated with prize-up replacement,grafting and internal fixation with screws.Type C2,C3 were treated with firm internal plate fixation.[Result]133 cases were followed up for 6~36months in 138 cases of tibial plateau fracture,average 23 months.Recovery of knee function were divided according to KDLMERI classification.Type B1B2B3 excellent rate 100%.C1 excellent 14cases,fair 2 cases.C2 excellent 10 cases,fair 8 cases.C3 excellent 6cases,fair 3 cases,badly 2 cases.Recovery of knee fruction excellent 118 cases(88.7%),fair and spoor 15cases(11.3%).[Conclusion]sinking degree of articular surface must be emphasized in treatment oftibial plateau fracture.Satisfied therapy effect can be obtained with early function exercise of knee joint.