| Objectives:(1) survey in epidemiological situation of tangshan adjacent area and Pilon fracture incidence, (2) The studies of Pilon MSCT fractures with the scanning (3) limited internal fixation (Orif open reduction and internal fixation combined with external fixation, by extension, the limited internal fixation (orif cut percutaneous comparing the effect of internal fixation.in the surgical treatment Hope clinicians provide more help.Methods: (1) assemble sorting 160 cases in December 2009 Pilon fractures of the relevant case by BingAnShi December 2006 design elements, questionnaires epidemical characteristics and 4 years of dynamic analysis situation to Pilon fracture of the registration, (2) were analyzed retrospectively in January 2007 to December 2007, 15 cases Pilon complex fracture of the clinical data by using recombinant technology MSCT pattern, A three-dimensional image ankle joint, crushing, and bone fracture, free condition (3) analyzed retrospectively 55 cases of surgical treatment of fractures and clinical data of December 2006 in December 2009 Pilon internal fixation (ORIF group as A group, 10 cases of limited internal fixation (ORIF limit (ORIF) combined with external fixation group 15 cases as group B, extension and internal fixation (ORIF group 15 cases as group C, limited internal fixation cut percutaneous MIPPO (15) group, and group D for patients with parenchyma damnification, fracture healing, complications and ankle clinical grade standard (1979 Mazur), on statistical analysis.Results: (1)In the December 2006 in December 2009 Pilon 160 cases treated by male was predominance, fracture, in young and middle-aged, with 30-50 years of age, causes to occupy the first falling injury, accident injury in the second, (2) MSCT can clear display fracture of Pilon ,MPR can display fracture lines series and bone structure change, fracture fragments of the space of the shift, joint dislocation. 55 cases the details of the, left, and can better show SSD 590 can display(3) Pilon fracture patients are followed, time is 10-18 months (mean13.6 Months), until the last follow-up, patients with osteoarthritis healing all, healing time 7-12 months (mean healing 9.1 Months);Has statistical significance in the course of fracture healing on timedistributing and ankle clinical grade standard (P < 0.05) but parenchyma damnification and complications situation has not statistical significance (P > 0.05).Conclusions: (1) in recent years, along with the rapid development of Chinese economy Pilon fractures in young and middle-aged are increasingly trend, male in predominance, falling injury, accident injury, as the main pathogenesis. (2) MSCT can clearly show by reconstruction technique the whole of Pilon fractures (three-dimensional structure) for clinical diagnosis and medical personnel, and formulate plans and surgical approaches, whether such reduction bone graft provides the reliable basis. (3) four treatments are the effective methods for Pilon fractures, but this kind of fracture characteristics are: distal tibia load produced different degree of fracture surfaces and cancellous bone compression and bone defect, articular cartilage of primary injury and joint destruction, because not smooth distal tibia of blood, soft tissue is weak, cannot provide good blood and protection. According to performance of the mechanism of injury Pilon fractures, so in treatment should differentiate: ORIF method is suitable for low energy Pilon fractures and soft tissue damage condition, Limited internal fixation (ORIF limit (ORIF) combined with external fixation and distribution ORIF extension method is suitable for adverse conditions, soft Pilon fracture of high-energy injuries etc. |
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