Mininally invasive surgery combined with Chinese dialectical theory of governance for treatment of complex Pilon's fracture / 中国矫形外科杂志

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.