pilon骨折诊疗进展

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1、授予单位代码10089学号或申请号20153360中国图书分类号R683.4HebeiMedicalUniversity硕士学位论文专业学位Pilon骨折诊疗进展研究生：赵栋导师：闫金成教授专业：外科学二级学院：第三医院2018年3月目录中文摘要··············································································································1英文摘要·········································

2、·····································································2综述Pilon骨折诊疗进展·············································································3致谢···················································································································1

3、6个人简历············································································································17中文摘要Pilon骨折诊疗进展摘要Pilon骨折是指胫距关节面受累的胫骨远端的骨折。在下肢骨折的病人中，Pilon骨折约占1％；在胫骨骨折的病人中，Pilon骨折约占3％～[1]10％。由于踝关节位置的特殊性，周围软组织的薄弱性，骨折周围血运差，所以Pilon骨折可导致严重的并发症。近年来，由于科技及医疗的进步，国内外学者对此

4、类骨折的诊治不断探索，并应用于实践，取得了显著的成效，现将有关方面的诊治策略进行综述。关键词：Pilon骨折，诊断，分型，治疗，3D打印技术1英文摘要TheAdvancedClinicalResearchofPilonFractureABSTRACTPilonFracture,asakindofdistaltibialfracture,damagedtheTibial-Astragalusarticularsurface.Itaccountedforabout1%oflowerlimbfractures,meanwhile3%-10%oftibialf

5、ractures.Anatomically,theanklehasspecialpositionandweaksofttissues,suchhaspoorbloodcirculations,whichcanresultinseverecomplications.Withtheprogressofscienceandtechnology,manyresearchesweredonetoexplorethediagnosisandtreatmentofsuchfractures,hopingtopromoteclinicalapplication.The

6、refore,theralateddiagnosisandtreatmentprotocolwasreviewedbelow.Keywords:PilonFracture,Diagnosis,Classification,Treatment,3DPrintingTechnology2综述Pilon骨折诊疗进展Pilon骨折是涉及承重的胫骨远端关节面的踝关节骨折，此概念是由放射学家Destot在1911年第一次提出并描述的。由于当今社会汽车的普及，由车祸导致的创伤病人越来越多,而安全气囊的应用和医院创伤救治体系的提高，使车祸的致死率降低。临床上，此类骨折

7、通常伴有腓骨远端骨折和严重的周围软组织挫伤。过去针对Pilon骨折的治疗策略主要是Rüedi[1]和Allgöwer医生提出的四步法。近年来，随着BO理念及科学技术的发展，[2]Pilon骨折的治疗方案有了更多的选择。依据张英泽院士出版的《临床创伤骨科流行病学》，该书根据骨折部位进行分类，共统计3864例成人Pilon骨折，得出，Pilon骨折占成人胫腓骨骨折的6.37%，占成人全身骨折的1.03%。流行病学统计如下：①男性发生Pilon骨折的风险高于女性；②Pilon骨折的在不同性别中的高发年龄一致，均为41-45岁；③Rüedi-AllgöwerI

8、型Pilon骨折的发生率最高，男性Pilon骨折以Ⅱ型为主，女性则以Ⅰ型为主。Pilon骨折作