Ii, Type Iii Pilon Fracture Surgery

Objective:To summarize the clinical data of the treatment of typeⅡand typeⅢPilon fractures,and investigating the treatment of typeⅡand typeⅢPilon fractures to guide the clinical work.Methods:From Jan 2002 to December 2006,our department had treated totally 24 cases Pilon fractures of typeⅡand typeⅢ,including 16 males and 8 females. The age is from 18 to 83,average 39.4;8 of traffic accident,9 of tumble,5 of falling and 2 of heavy pressing trauma.According to the Rüedi- Allgower classification of Pilon fracture there were 11 of typeⅡand 13 of typeⅢ.16 of close fractures were adopted open reduction and internal fixation in 4 to 15 days after wounded,average 9.25 days.7 of 8 open fractures were primarily cleared at start and calcaneus traction was used,then open reduction and internal fixation after 20 days.Processing initiative + passive ankle function exercise after operation.Results:20 cases were followed up 8 to 21 months,average 15.7 months. Evaluated by the Burwell-Charnley(1965)Pilon fracture reduction radiology score:11 cases were anatomize reduction and 10 were function reduction,the excellent and good rate was 87.5%and the Tometta(1993)Pilon fracture clinical treatment score:9 were excellent,7 were good,the excellent and good rate was 80%.Conclusion:Pilon fracture is commonly intra-articular fracture.We recommend: 1.Related operation and according to the position of the main fracture block to decide the approach of operation.2.The fracture were fixed by plate or limited fixed by screws and Kirscher-wires according to the damage level.3.We adopt the rule of using minimally invasive techniques to reduce the post-operative complications and processing initiative +passivity ankle function exercise to increase the recovery of the ankle function.