Mauffrey Cyril, Vasario Gabriel, Battiston Bruno, Lewis Charlie, Beazley James, Seligson David
University of Louisville Hospital, Louisville, KY, USA.
Acta Orthop Belg. 2011 Aug;77(4):432-40.
Tibial pilon fractures are challenging to treat, as they are typically intra-articular and associated with extensive soft tissue damage. We briefly review the anatomy of the distal tibia, as well as the pathophysiology of pilon fractures. The treatment of tibial pilon fractures is still controversial in the literature, and we present some of the available options. Consideration is also given to peri-operative complications, such as preoperative oedema and blistering and late postoperative traumatic arthritis. Finally, we propose a treatment algorithm (used in our institution), taking into account the level of associated soft tissue injuries. The use of a 2-phase treatment protocol is recommended; however, to date, no absolute treatment protocol exists for these injuries.
胫骨平台骨折的治疗颇具挑战性，因为它们通常为关节内骨折且伴有广泛的软组织损伤。我们简要回顾一下胫骨远端的解剖结构以及平台骨折的病理生理学。胫骨平台骨折的治疗在文献中仍存在争议，我们将介绍一些可行的治疗方案。同时也会考虑围手术期并发症，如术前水肿、水泡形成以及术后晚期创伤性关节炎。最后，我们提出一种治疗算法（在我们机构使用），该算法考虑了相关软组织损伤的程度。建议采用两阶段治疗方案；然而，迄今为止，对于这些损伤尚无绝对的治疗方案。
