Pilon骨折的外科治疗(英文加翻译)

Objective:Todiscussthemethods,timingandclinicaloutcomesofsurgicaltreatmentforopenpilonfractures.Methods:FromApril2003toJuly2008,28patientswithopenpilonfracturesweretreated.AllhadtypeCfracturesaccordingtotheArbeitsgemeinschaftfürosteosynthesefragen–AssociationfortheStudyofInternalFixation(AO/ASIF)classification.Threeoperativemethodswereapplied,themethodsbeingdeterminedbythetypesoffracture,softtissuedamageandtimeintervalafterinjury.trauma创伤classification分类；分级debridement清创术、扩创术anatomicreduction解剖复位theArbeitsgemeinschaftfürosteosynthesefragen瑞士骨折内固定协会/AOBurwell-Charnleyscore骨折复位放射学评价标准1965Orthopaedic骨科的；整形外科的Complication并发症sloughing蜕皮；脱落post-traumaticarthritis[ɑː'θraɪtɪs]创伤后关节炎Thorough彻底地'θʌrəanti-infectivemedication抗感染药物occurrence[ə'kʌr(ə)ns}发生tibial['tɪbɪəl]胫骨的talus['teɪləs]距骨softtissuedegloving(套袖状的)软组织撕裂metaphyseal干骺端的Sevencasesweretreatedbydebridementandinternalfixationwithplate;19bylimitedinternalfixationcombinedwithexternalfixation;and2bydelayedsurgery.TheclinicaloutcomeswereevaluatedbytheBurwell-Charnleyscore.Results:Allcaseswerefollowedupforfrom6to48months(average24months).TheBurwell-Charnleyscoreofclinicaloutcomes:anatomicreductionachievedin12cases,functionalreductionin15,andunsatisfactoryreductionin1.Thehealingtimewasfrom2.5to11months(average4.7months).Twocaseshaddelayedunion.AccordingtotheAmericanOrthopaedicFootandAnkleSociety(AOFAS)scalefortheanklejoint,therewereexcellentresultsin8cases,goodin14,fairin5andpoorin1.Complicationsincludedfourcasesofskinsuperficialsloughing,twoofsuperficialinfection,oneofdeepinfection,twoofdelayedfractureunionandtenofpost-traumaticarthritis.Thoroughdebridement,properuseofanti-infectivemedication,appropriatebonegrafting,andpostoperativeanklefunctionexercisecanreducetheoccurrenceofcomplications.trauma创伤classification分类；分级debridement清创术、扩创术anatomicreduction解剖复位Complication并发症sloughing蜕皮；脱落post-traumaticarthritis[ɑː'θraɪtɪs]创伤后关节炎Thorough彻底地'θʌrəanti-infectivemedication抗感染药物occurrence[ə'kʌr(ə)ns}发生tibial['tɪbɪəl]胫骨的；tibia['tɪbɪə]胫骨talus['teɪləs]距骨softtissuedegloving软组织撕裂lowerlimbfractures下肢骨折degloving套袖状撕裂metaphyseal干骺端的articulardepression关节压缩weightbearingarea负重区implant内植物approach方法correspondencen.通信；一致；相当DOI：数字对象唯一标识符bilaterally[bai'lætərəli]双边地malleolus[mæ'liːələs]踝clinic临床；诊所motor发动机vehicle[ˈviːəkl]（车辆）accidentOpenfracturescomprisesabout10%to30%ofallpilonfractures3.Thesefracturesareoftenassociatedwithsignificantsofttissuedegloving,metaphysealbonedefectsandarticulardepression.IntroductionPilonfractureconstitutes1%ofalllowerlimbfracturesandabout3%to10%oftibialfractures1,2.Itisusuallytheresultofhighenergyinjurytotheweightbearingareaofthelowerendofthetibiabythetalus.Conclusion:Itisimportanttoperformappropriatesurgeriesforopenpilonfractureaccordingtofractureclassification,differentdamagetoskinandtissueandtimeintervalafterinjury.Keywords:Delayedoperation;Externalfixators;Fracturesopen;InternalfixatorsInspiteofimprovementsinsurgicalapproachesandimplants,treatmentoftibialpilonfracturesremainschallenging4.Inthepresentstudy,wediscussthemethods,timingandclinicaloutcomesofsurgicaltreatmentforopenpilonfractures.AddressforcorrespondenceXian-tieZeng,MD,DepartmentofTrauma,TianjinHospital,Tianjin,China300211Tel:[phone];Fax:[phone];Email:[e-mail]:19July2010;accepted5October2010DOI:10.1111/j.1757-7861.2010.00113.xMaterialsandMethodsPatientdataFromApril2003toJuly2008,28patientswithopentibialpilonfracturesweretreatedinourhospital.Therewere21menand7womenwithanaverageageof36.5years(range,19–61years).Tenpatientswereinjuredontheleftside,17ontherightand1bilaterally(aclosedfractureoftherightmalleolus（踝）wasnotcounted).Theintervalbetweeninjuryandpresentationtoourclinicrangedfrom1to14hours(average,5.1hours).Themechanismsofinjurywerehigh-energyfallsin10cases,motorvehicleaccidentsin12,crushinginjury（挤压伤）in4cases,andsportsinjuriesin2.ThefractureswereclassifiedaccordingtotheAO/ASIFsystem:7wereclassifiedastypeC1,17typeC2,and4typeC3.OpensofttissuedamagewasgradedaccordingtotheGustilosystem:4caseswereclassifiedasGustiloI,21GustiloII,2GustiloIIIA,and1GustiloIIIB.acetabularæsə'tæbjulə]髋臼的fibular腓骨的;fibula腓骨femoral股骨的Calcaneal[kæl'keiniəl跟骨的craniocerebral[,kreiniəusi'ri:brəl颅脑的protocol方法、协议presentingwith伴随restoration恢复tibia胫骨cancellous['kæns(ə)ləs]松质骨insertion插入modified改进的cloverleaf三叶草形Anteromedial前内侧的medial内侧的posterolateral后外侧的lateral外侧的constraint约束、限制keepinginmind牢记anteroposterior前后的；正位（影像）Combinedinjuriesincludedfibularfracturesin25cases,spinalfracturesin2,upper-armfracturesin2,ribfracturesin2,femoralfracturein1,acetabularfracturein1,calcanealfracturein1,andcraniocerebraltraumain1.demonstrating显示Calcaneus（口Ki尼尔斯）：跟骨metatarsal跖骨的anklemortise踝关节Kirschner克氏pin克氏针MethodsOneofthreedifferentsurgicalprotocolswasperformedinallpatients,thechoicebeingbasedontheconditionofsofttissue,typeoffractureandlengthofintervalbetweeninjuryandpresentationfortreatment.Debridement,openreductionandinte