关键词: 手术, 胫骨, Pilon骨折

Abstract: 【Abstract】〓Objective〓To investigate the surgical timing and surgical design of distal tibial Pillon fracture. Methods〓A total of 45 cases with distal tibial Pilon fractures in our hospital from 2007 January to 2015 January were retrospectively analyzed. According to Ruedi-Allgower classification, patients were divided into Ruedi-Allgower type II group (n=23) and Ruedi-Allgower type III group (n=22). Surgical procedure involved three approaches, open reduction and internal fixation, two-stage delayed open reduction internal fixation and external fixation combined with limited internal fixation effect. The time and mode of operation were analyzed in two groups. Results〓There was no significant difference in different operation mode. The operation of Ruedi-Allgower type II was mainly performed in 7-10 day after trauma, and Ruedi-Allgower type III in 6-8 h. In patients with Ruedi-Allgower II, III, open reduction internal fixation (ORIF) surgery treatment had better clinical effect than the early open reduction and internal fixation, but bone healing time was significantly less than that of open reduction and internal fixation in early stage (P<0.05). The comparison of treating excellent rate and complication incidence among different surgical way had no significant difference(P>0.05), operation time of two-stage delayed open reduction internal fixation and external fixation combined with limited internal fixation were significantly shorter than open reduction and internal fixation (P<0.01), osseous healing time of two-stage delayed open reduction internal fixation was significantly shorter than external fixation combined with limited internal fixation (P<0.01), and osseous healing time of two-stage delayed open reduction internal fixation was significantly shorter than open reduction and internal fixation(P<0.05). Conclusion〓Accurately grasps the distal tibial Pilon fracture operation time, it preferred two-stage delayed open reduction internal fixation by comprehensively evaluating fracture degree, it helps significantly shortening operation time and osseous healing time.

Key words: Pilon fracture, Tibial, Surgery