李燦楊(Li Canyang，Dept Foshan Hosp Tradit Chin Med Foshan，Guangdong 528000)…∥Chin J Clin Basic Orthop Res.－2010，2(2).－144～147

Dynamic external fixator combined with limited internal fixation for Pilon reactures

李燦楊(Li Canyang，Dept Foshan Hosp Tradit Chin Med Foshan，Guangdong 528000)…∥Chin J Clin Basic Orthop Res.－2010，2(2).－144～147

ObjectiveTo evaluate effects of manipulative reduction，dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.MethodsFrom January 2007 to June 2009，manipulative reduction，dynamic external fixator combined with limited internal fixation were performed to treat 23 cases of complex Pilon fractures which were 14 of typeⅡand 9 of typeⅢ according to Ruedi-Allgower Classification.ResultsAll of the operations were performed safely.The average operative time was 57 min with average estimate blood loss of 75 mL.During the operation，no nerve or vascular injuries occured.Twenty-three cages were followed up for 6 to 24 months with an average of 17 months.No screw loosening or deep wound infection occured.There were 3 cases with superficial pin tract infections who were cured through local dressing，1 mild ankle inversion and 1 traumatic arthritis.Fracture union was seen in all patients，with an average healing time of 4.2 months.According to Mazur ankle evaluation grading system，the results were excellent in 15 cases，good in 5 cases，fair in 2 cases and poor in 1 case，the excellent and good rate was 87.0%.ConclusionThe method of manipulative reduction，dynamic external fixator and limited internal fixation is a good choice to reduce soft tissue injuries caused by open reduction and to aviod the destroy to blood supply of fracture site due to the complex Pilon fractures with advantages of less blood loss，minimal invasion，shorter operative time and low fracture nonunion incidence.12 refs，1 fig.

(Authors)