改良前内侧入路治疗Ruedi-Allgower Ⅲ型Pilon骨折的疗效

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Abstract Objective To explore the clinical outcomes of modified anteromedial approach in the treatment of Ruedi-Allgower Ⅲ Pilon fractures.Methods 38 patients with closed Ruedi-Allgower Ⅲ Pilon fracture were treated with open reduction and internal fixation through ankle modified anteromedial approach in our department retrospectively from January 2015 to January 2018.There were 30 males and 8 females with an average age of(48.0±11.7 )(range：23 to 76 )，including 19 left and 19 right sides.The blood loss，operation time，American 0rthopedic Foot and Ankle Society(AOFAS)and the complications were analyzed.Results The average follow-up of 38 patients was(17.58±6.82)months(range：12 to 36 months).The incisions displayed grade A healing in 37 patients.One patient(2.6%)suffered from skin necrosis of superficial incision.There was no case of infection，delayed union or nonunion.The average bleeding were(99.87±53.28)mL and the average operation time were(134.39±26.11)min.According to evaluation criteria of Burwell-Charnley，there were 32 excellent cases，5 good and 1 poor and the excellent-good rate was 97.4%.At the last follow-up，the average AOFAS score of ankle were(93.66±3.76)points.30 cases were excellent，7 cases were good，and 97.4% of patients showed excellent good results.Conclusion The Modified anteromedial approach of ankle is an effective method for the treatment of Ruedi-Allgower Ⅲ Pilon fractures.It has little interference to the soft tissue and satisfactory effect.It is worthy of further clinical study.

Key words： pilon fracture ruedi-allgower type Ⅲ modified anteromedial approach internal fixation

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