目的:探讨分阶段治疗策略在Rüedi-Allg(o)wer Ⅲ型Pilon骨折治疗中应用的临床效果.方法:收集本院收治的28例Rüedi-Allg(o)wer Ⅲ型Pilon骨折共33肢的资料,其中开放性骨折25肢,闭合性骨折8肢.采用一期手法复位后牵引或石膏托单托、外固定支架固定,二期行切开复位内固定或有限切开内固定加超踝关节外固定支架固定手术的分阶段治疗策略.结果:本组24例(26肢)获得随访,平均18个月.参照Burwell-Chamley放射学评价标准术后1年骨折复位优良率为86.2%.骨折愈合时间平均3.6个月.踝关节功能参照Tornetta临床治疗结果评价标准术后1年优良率为86.2%.无深部感染、内固定松动断裂及螺钉进入踝关节间隙等并发症.结论:一期外固定或牵引、二期内固定的分阶段治疗策略是临床处理Rüedi-Allg(o)wer Ⅲ型Pilon骨折的可行方法,术后功能恢复良好.

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