| Objective:Observe curative effect of the polyaxial locking plate combined with arthroscopy technique in treating high-energy Pilon fractures.Methods: 22 cases with high energy Pilon fractures were cured from Feb, 2010 to Apr,2013. CT-dimensional reconstruction was used before operation for showing the morphology of fracture and articular surface. Polyaxial locking plate fixed distal tibia fractures under arthroscopy assistance during operation. Operation effect was evaluated through analyse the operation time,blood loss during operation,radiographic morphometry results of ankle joint in the last follow-up imaging and ankle function assessed by Mazur score.Results: All 22 cases were followed up for a mean time of 13.3 months(10-24month).Fractures all healed in 7-19 weeks(mean time 11.7 weeks). One case suffered skin necrosis and accepted flap transposition coverage. There was no other complications such as deep infection, nonunion and plate exposure. Ankle CT examination were performed at the time of the last follow-up and one case showed less flat of distal tibia joint face but with no osteoarthritis. Qualified ratio of ankle joint function after surgery assessed by Mazur score was 86.4% consisting of excellent 15 cases(score> 92), good 4 cases(score87- 92) and acceptable 3 cases(score 65-87). According to Tornetta standard, qualified ratio was 90.91% consisting of excellent 16, good 4 and acceptable 2.Conclusions: The study affirmed the curative effect of Polyaxial locking plate combined with arthroscopic techniques in treating pilon fractures. The operation can be satisfied in protecting ankle soft tissue, repairing the joint ligament injury and improving the fracture healing rate and ankle function. Ankle osteoarthritis also decreased. Compared with other operation, this method has advances such as less surgical trauma, reliable fixation and less internal fixation used. It is a worthy way for traumatic orthopedic doctors to try. |
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