Leonard M, Magill P, Khayyat G
Our Lady Of Lourdes Hospital, Drogheda, Co. Louth, Ireland.
Int Orthop. 2009 Aug;33(4):1149-53. doi: 10.1007/s00264-008-0629-5. Epub 2008 Jul 25.
The pilon fracture is a complex injury. The purpose of this study was to evaluate the outcome of minimally invasive techniques in management of these injuries. This was a prospective study of closed AO type C2 and C3 fractures managed by early (<36 hours) minimally invasive surgical intervention and physiotherapist led rehabilitation. Thirty patients with 32 intra-articular distal tibial fractures were treated by the senior surgeon (GK). Our aim was to record the outcome and all complications with a minimum two year follow-up. There were two superficial wound infections. One patient developed a non-union which required a formal open procedure. Another patient was symptomatic from a palpable plate inferiorly. An excellent AOFAS result was obtained in 83% (20/24) of the patients. Early minimally invasive reduction and fixation of complex high velocity pilon fractures gave very satisfactory results at a minimum of two years follow-up.
Pilon骨折是一种复杂的损伤。本研究的目的是评估微创技术治疗这些损伤的效果。这是一项对闭合性AO C2型和C3型骨折进行前瞻性研究，采用早期（<36小时）微创外科手术干预及由物理治疗师主导的康复治疗。30例患者共32处胫骨远端关节内骨折由资深外科医生（GK）进行治疗。我们的目标是记录至少两年随访期的结果及所有并发症。发生了两例表浅伤口感染。一名患者出现骨不连，需要进行正式的切开手术。另一名患者因可触及的钢板下方出现症状。83%（20/24）的患者获得了优秀的美国足踝外科协会（AOFAS）评分结果。对复杂的高能量Pilon骨折进行早期微创复位和固定，在至少两年的随访中取得了非常满意的结果。
