Clinical Study Of â…¡ â…¢ Type Pilon Fracture

Objective: To review the patients who suffer Ruedi-Allgower II III pilonat Jilin university the3rdclinical hospital. Apply statistics to analysis therelationship between the age, surgical operation method, surgicaloperation moment, complication disease preventive treatment of theRuedi-Allgower II III Pilion and Mazur ankle joint function scoring. Tocompare the curative effect of first phase incision reduction and internalfixation, limited internal fixation, Two-stage delayed open reduction andinternal fixation. To provide reference and basis for the clinical work ofthe II III pilon treatment.Method:â‘ Consult the patients who suffered Rurdi-Allgower II III Pilonin hosipital during Jan.2008to Jan.2012by iconography file and Theelectronic medical record system.â‘¡Fl.up and register the related part,make Dynamic observation and analysis about the operation and nearly4year situation. Apply the MSCT when necessary, Three-dimensionalreconstruction. Observe the damage of joint, the damage of flab,dissociate of the bone block.â‘¢Divide into3groups according to curingmethod:26first phase incision reduction and internal fixation in groupA.20limited internal fixation in group B.28Two-stage delayed openreduction and internal fixation in group C.â‘£Scoring Mazur joint by thedamage of skin, articular facet, flab along with surgery operation time,the amount of bleeding during operation, postoperative comlications,apply statistics and compare by the SPSS software, make the single-factoranalysis, with meaningful statistics (P<0.05), regress to reject by step.Analysis of the kinds of factors to the scoring to get the final result toguide clinical treatment.Result: Get the74patients who suffer II III pilon during2008to2012,totally get the complete fl.up(8months to4years which average is2years and2months). Male52and22for female. Mainly the young andmiddle-aged (30to50which average is38.2). The nosogenesis is mainlyfalling and car accident(68%). Scoring according to Mazur joint functionafter operation, the result come to the excellent rate is53.8%,16for typeII,14for type III. The excellent rate for group B is40%,10for type II,10for type III. The excellent rate for group C is71.4%,16for type II,12for type III. The results of applying single-factor logistic regression modeshows that the highest OR41.299is for the quality of reduction after operation,1.556for the operation time. But for operation method, skin,the flab situation make important influence to result.Conclusion: It can be chosen different surgery operation methodaccording to the difference between II III crashed fracture and flab andskin. There is obvious difference among3curing methods in clinical,radiologia and complication for the group of case, the best treatmenteffect fr group C. Choose the correct operation time, Two-stage delayedopen reduction and internal fixation can recover joint availably, reducethe complications appearance obviously, get excellent clinical effect, turnout to be the best curing method for Ruedi-Allgower II III Pilon...