摘要：目的：探讨Rüedi-AllgowerⅢ型Pilon骨折不同的治疗方法、手术时机及并发症的防治。方法：1999年8月至2006年2月收治Ⅲ型Pilon骨折患者25例，年龄22～65岁，平均37.8岁。开放性骨折9例，闭合性骨折16例，合并腓骨骨折21例。胫骨骨折钢板固定14例，螺钉加克氏针固定4例，外固定架结合有限内固定5例，踝关节融合2例。结果：术后随访6～80个月，平均37个月。按Mazur评分标准：优9例，良11例，中3例，差2例，优良率80%。结论：影响复杂Pilon骨折预后的因素很多，术前对损伤作出正确的评估，正确选择手术时机，选择合适的治疗方法是治疗成功的关键。

    关键词： Pilon骨折； 骨折固定术； 手术时机

    Surgical Treatment of Complicated Pilon Fracture

    DAI Yong-ping, DING Jian, LU Hong-xu, et al

    (The First People's Hospital of Rugao, Jiangsu Rugao 226500, China)

    Abstract： Objective： To discuss different procedures, time of surgery and prevention of complications for type Ⅲ Pilon fractures. Method： Follow-up were done for 25 patients with tibial Pilon fracture who had been treated in our department betweeb August 1999 and February 2006. Their average age was 37.8 years (ranging from 22 to 65 years). 9 cases were open fracture, and 16 cases were closed fracture. 21 cases were accompanied with fibular fracture. 14 cases of tibial fracture fixed with plate, 4 cases were treated with limited internal fixation with screw and Kirschner wire, 5 cases were treated with the external fixators combined with limited internal fixation and 2 cases with arthrodesis. Result： With the 6～80 months follow-up after the operation (average 37 months).According to Mazur’s criteria, the result was evaluated as excellent in 9 cases, good in 11 cases, fair in 3 cases and poor in 2 cases. The excellent and good recovery rate was 80%. Conclusion： Many factors can affect the prognosis of tibial Pilon fracture, the key points for a successful operation are careful assessment of the injury, right procedure and timing of surgery. ......