Scolaro John A, Broghammer Francis H, Donegan Derek J
*Department of Orthopaedic Surgery, University of California, Irvine, Orange, CA; †School of Medicine, University of California, Irvine, Orange, CA; and ‡Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA.
J Orthop Trauma. 2016 Nov;30 Suppl 4:S12-S16. doi: 10.1097/BOT.0000000000000697.
The optimal treatment strategy for distal tibia fractures, especially those with intraarticular extension, remains controversial. Although open reduction and internal fixation with a plate and screw device is commonly performed for these injuries, the risk of soft tissue complications using this approach is significant. Staged treatment protocols and alternative means of fixation have been proposed to address these undesired events. Although potentially more technically demanding than fixation of diaphyseal or extraarticular tibial fractures, intramedullary nail (IMN) fixation of simple intraarticular distal tibia fractures is a viable treatment alternative with unique advantages. This article presents a review of the literature and rationale for intramedullary tibial nail fixation of simple intraarticular distal tibia fractures and a surgical approach commonly utilized for successful implementation.
胫骨远端骨折的最佳治疗策略,尤其是那些合并关节内延伸的骨折,仍存在争议。尽管对于这些损伤通常采用钢板螺钉装置进行切开复位内固定,但采用这种方法出现软组织并发症的风险很大。已提出分期治疗方案和替代固定方法来应对这些不良事件。虽然与骨干或关节外胫骨骨折的固定相比,技术要求可能更高,但简单关节内胫骨远端骨折的髓内钉(IMN)固定是一种具有独特优势的可行治疗选择。本文综述了简单关节内胫骨远端骨折髓内钉固定的文献和理论依据,以及成功实施该方法常用的手术入路。