胫骨Pilon骨折及创伤性关节炎防治的临床研究

【作者】 杨自荣；

【导师】 许建安；

【作者基本信息】 南京中医药大学 ， 中医骨伤科学， 2004， 硕士

【摘要】 目的：为Pilon骨折探索出一较为合理的治疗方案，从而最大限度地减少创伤性关节炎的发生，恢复关节的功能。 方法：本文文献部分系统地介绍了Pilon骨折的相关解剖、发病率、危险因素以及发病机制等。着重对Pilon骨折的诊断分型及国内外各种治疗方法进行了系统回顾；临床研究部分则将2002～2004年收治的21例Pilon骨折随机分为两组，实行切开复位内固定后治疗组早期被动功能锻炼(CPM)加中药熏洗患部，对照组只实施患肢主动功能练习。 结果：通过文献研究总结出一条合理的Pilon骨折的治疗方案，切开关节面解剖复位内固定，术后早期被动活动踝关节，外加中药熏洗患部。两组患者按Mazur评分标准，经过5个月～18个月的随访，治疗组优良率达69.2％，而对照组只达50％。 结论：切开关节面解剖复位，采用钢板内固定，术后早期踝关节被动功能锻炼加中药熏洗患部都是Pilon骨折较为理想的治疗方法，能有效地预防创伤性关节炎的发生，改善关节功能。更多还原

【Abstract】 Objective: To seek out an optical treatment scheme of Pilon fracture, and then to prevent posttraumatic arthritis ,restore function of ankle .Methods: In the literature section of this academic thesis ,author reviewed systematically the anatomy , mobility , dangerous factors and pathogenesis of Pilon fracture and so on .And specially stressed on diagnosis , classification and treatment of Pilon fracture .In clinical study section ,2leases which collected from 2002 to 2004 had been randomed into treatment -group and control-group. 13 in treatment and 8 in another. After ORIF ,cases in treatment group were managed by early CPM and xtinxi ,cases in control were treated only by early active motion .Result: We made out a rational treatment scheme of Pilon fracture through literature study: open reduction internal fixation , postoperative CPM and local xunxi ,which proved useful optimal by our clinical study .According to Mazur score, the rate of excellent was 69.2%, while50 %in control.Conclusion: Open reduction and internal fixation , postoperative CPM and local xunxi with Chinese medicine is an ideal management of Pilon fracture .It can effectively prevent the posttraumatic arthritis .更多还原