Yu Gao-feng, Ma Jiang-tao, Yu Min, Pan Li-qun, Zhang Liang, Liang Shou-xin
Zhongguo Gu Shang. 2015 Jun;28(6):527-30.
To explore clinical characteristics and treatment of posterior Pilon fracture.
From January 2011 to January 2013,18 patients with posterior Pilon fracures were treated. Among them, 13 were male and 5 were female, aged from 22 to 63 years old, with an average age of 46. All the patients were closed fractures. Open reduction and internal fixation were performed after swelling subsided, lateral malleolous and posterior Pilon fracture were exposured through lateral approach on healthy side, plates were used to fixed,screws or small plates were used to fix the posterior prominence of medial malleolus after changed to supine position. AOFAS scoring were applied to evaulate clinical effects.
All patients were followed up with an average of 22(ranged, 12 to 48)months. All patients obtained satisfactory reset except one patient. All factures were recovered well with an average healing of 11 weeks. According to AOFAS score at the final following up, 7 cases were excellent,2 cases were moderate, and the total score was 86.8±9.2.
Posterior Pilon fracture is not rare in clinical, its mechanism of injury, traumatic anatomy, surgical procedure and prognosis are different from that of classical ankle fracture and Pilon fracture.
探讨后Pilon骨折的临床特点及治疗方法。
2011年1月至2013年1月，收治18例后Pilon骨折患者。其中男性13例，女性5例，年龄22～63岁，平均年龄46岁。均为闭合性骨折。肿胀消退后行切开复位内固定，于健侧经外侧入路显露外踝及后Pilon骨折，用钢板固定，改为仰卧位后用螺钉或小钢板固定内踝后突。采用AOFAS评分评估临床疗效。
所有患者均获随访，平均随访22（12～48）个月。除1例患者外，其余患者均获得满意复位。所有骨折均愈合良好，平均愈合时间为11周。末次随访时根据AOFAS评分，优7例，良2例，总分86.8±9.2。
后Pilon骨折在临床上并不少见，其损伤机制、创伤解剖、手术方法及预后与经典的踝关节骨折和Pilon骨折不同。
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