Herrera-Pérez M, Andarcia-Bañuelos C, Ayala-Rodrigo A, País-Brito J L
Acta Ortop Mex. 2013 Mar-Apr;27(2):71-7.
High-energy tibial pylon fractures represent some of the most severe injuries of the ankle joint and currently represent a challenge for the orthopedic surgeon. These are usually polytraumatized patients and before admitting them into the traumatology unit, spinal cord, pelvic or thoracoabdominal injuries should be ruled out. Due to the special anatomy of the area, its thin skin cover and subcutaneous location, soft tissues are usually severely affected and this is key when choosing the time for a surgical intervention. Although the definitive treatment of these injuries is controversial, the so called two-stage treatment seems to predominate in order to minimize soft tissue iatrogenic injuries applying the concept of orthopedic damage control of the limb. We present the preliminary results of 10 patients operated with this method at our center.
高能胫骨平台骨折是踝关节最严重的损伤之一，目前对骨科医生来说是一项挑战。这些患者通常为多发伤，在收入创伤科之前，应排除脊髓、骨盆或胸腹损伤。由于该区域特殊的解剖结构、皮肤覆盖薄以及位于皮下，软组织通常会受到严重影响，这在选择手术干预时机时至关重要。尽管这些损伤的 definitive 治疗存在争议，但为了将肢体骨科损伤控制概念应用于最小化软组织医源性损伤，所谓的两阶段治疗似乎占主导地位。我们展示了在我们中心采用这种方法进行手术的 10 例患者的初步结果。 （注：“definitive”此处暂保留英文未翻译，因为在医学语境中可能有特定专业含义需结合更多背景确定准确中文表述）
