Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.
J Am Acad Orthop Surg. 2011 Oct;19(10):612-22. doi: 10.5435/00124635-201110000-00005.
Pilon fractures are challenging to manage because of the complexity of the injury pattern and the risk of significant complications. Variables such as fracture pattern, soft-tissue injury, and preexisting patient factors can lead to unpredictable outcomes. Avoiding complications associated with the soft-tissue envelope is paramount to optimizing outcomes. In persons with soft-tissue compromise, the use of temporary external fixation and staged management is helpful in reducing further injury and complications. Evidence in support of new surgical approaches and minimally invasive techniques is incomplete. Soft-tissue management, such as negative-pressure dressings, may be helpful in preventing complications.
胫骨骨折的处理具有挑战性，这是因为其损伤模式复杂，且存在发生重大并发症的风险。骨折类型、软组织损伤和患者的固有因素等变量会导致不可预测的结果。避免与软组织相关的并发症是优化治疗效果的关键。对于软组织受损的患者，使用临时外固定和分期管理有助于减少进一步的损伤和并发症。支持新手术方法和微创技术的证据并不完整。软组织管理，如负压敷料，可能有助于预防并发症。
