| Objective To explore the clinical efficacy of Pilon fractures based on the principle of three-column theory, and summarize the guiding significance of three-column theory for surgical treatment. Methods Retrospective analysis of Jan 2013 to Feb 2016, 41 cases of Pilon fractures in accordance with the principle of the three pillars to guide the operation of open surgery and more than 1 year of complete follow-up data of the case data, 32 males and 9 females; age 22 ~ 84 years old, an average of 45.6 years old, are unilateral fractures, 19 cases of high fall injury, traffic injury in 12 cases, 10 cases of walking sprain. According to the three-column theory, there were 7 cases of lateral column fractures, 5 cases of internal medial column fractures, 16 cases of medial and lateral column fractures, 13 cases of internal and external posterior column fractures. The surgical incision is selected to enter the main fracture, and the plate is fixed in the direction of the each column. 8 weeks later, Burwell-Charnley fracture reduction Radiotherapy standard for evaluation of fracture reduction, 6 months later, the American Society of Ankle Surgery (American Orthopedic Foot and Ankle Society, AOFAS) ankle - hind foot function score are used for evaluation of ankle joint function recovery. Results Forty-one patients were followed up for 12 to 26 months (mean, 15 months). All patients were fracture healing, no incision infection, suppurative, deep vein thrombosis, 2 cases of soft tissue around the incision soft tissue necrosis, 1 case of incision fat necrosis liquefaction and other complications, were replaced after healing. Burst-Charnley radiology standard assessment: anatomical reduction in 30 cases, the general reduction of 11 cases, the reduction of 0 cases. AOFAS ankle - hind foot function score of 70 to 91 points, an average of 81.6 points. Conclusion It is effective in Pilon fracture three-column theory to guide the surgical treatment , and can make the fracture better cure and internal fixation options, to achieve better results, worthy of clinical application. |
