人工骨治疗胫骨Pilon骨折合并小腿骨筋膜室综合征的临床分析(1)
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【摘要】目的：通过对胫骨闭合性Pilon骨折的植骨治疗以及骨筋膜室综合征处理方法的分析，验证出最佳的治疗方案。方法：回顾性分析2005年6月～2011年1月胫骨闭合性Pilon骨折合并小腿骨筋膜室综合征29例，根据临床资料进行Ruedi-Allgower分型，比较植骨和非植骨、骨筋膜室综合征处理和手术的临床疗效。结果：随访4～25个月(平均16.3个月)，2种方案的按Ruedi-Allgower分型，各分组在严重程度上无明显差别。按照Helfet的评定标准各组临床疗效无明显差别，随访并发症有明显差别，其中植骨优于未植骨，OCS手术优于非手术。结论：治疗效果决定于损伤程度、复位质量、处理并发症及时和固定的稳定性，治疗方案的选择在复杂性骨折的治疗和预后中起着重要的作用。
【关键词】人工骨；Pilon骨折；骨筋膜室综合征；闭合性骨折；治疗。
Pilon fractures with Osteofascial compartment syndrome of Bone treatment of Clinical analysis
【Abstract】Objective: By Pilon fractures of tibial bone grafting and treatment of compartment syndrome in the analysis verify the best treatment.Methods:Since Jun.2005 to Jan.2011,29 patients of closed tibial Pilon fractures were According to clinical data Ruedi-Allgower classification, In each group no significant difference in severity. The assessment criteria in accordance with Helfet clinical efficacy in each group no significant difference in follow-up complications were significantly different.,Which is better than no bone graft, OCS is better than non-surgical procedure. The assessment criteria in accordance with Helfet groups no significant difference in clinical efficacy, significant differences were followed up for complications, including bone than those without bone graft, OCS is better than non-surgical procedure.Results:All cases were followed-up from 4 months to 25 months(average 16.3 months), 2 program were according to Ruedi-Allgower classification, which had no significant difference in severity.Conclusion: Treatment are dependent on the degree of injury and the quality of reduction and the management of complications in season and stability of the reduction. Complex fractures of the treatment and prognosis play an important role in the choice of treatment.
【Key Words】Artificial bone; Pilon fracture; Osteofascial compartment syndrome; closed fracture.
Pilon骨折是关节内骨折中较难治疗的一种复杂创伤性骨折，伤后同时并发骨筋膜室综合征(osteofascial compartment syndrome,OCS)时若不及时发现，正确处理，将导致小腿部肌肉坏死影响功能，重者截肢、死亡等[1]。我科自2005年6月以来接诊的Pilon骨折合并骨筋膜室征的患者中有29例得到随访，现就其治疗方法及影响临床效果的因素作一回顾性分析。
1 临床资料与方法
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