Hoekstra Harm, Rosseels Wouter, Rammelt Stefan, Nijs Stefaan
University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium; KU Leuven - University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium.
KU Leuven - University of Leuven, Faculty of Medicine, B-3000 Leuven, Belgium.
Injury. 2017 Jun;48(6):1269-1274. doi: 10.1016/j.injury.2017.03.016. Epub 2017 Mar 19.
The treatment of fractures of the posterior pilon is a timely issue. Restoration of the integrity of the incisura fibularis and subsequent anatomic reduction of the fibula are essential for reconstruction of the ankle mortise after trauma, and syndesmotic stability. Inappropriate treatment ultimately will lead to a poor functional outcome and quality of life. Open reduction and direct internal fixation through a posterolateral or posteromedial approach are increasingly preferred over indirect reduction and anteroposterior screw fixation. The posteromedial approach, although elegant, straightforward, and offering an excellent exposure of the fracture site, is used less frequently than the posterolateral approach. In this technical note we describe the posteromedial approach for the treatment of posterior pilon fractures in a step-by-step fashion. We will discuss the indications, its benefits and limitations.
后踝骨折的治疗是一个亟待解决的问题。腓骨切迹完整性的恢复以及随后腓骨的解剖复位对于创伤后踝关节 mortise 的重建和下胫腓联合稳定性至关重要。不恰当的治疗最终将导致功能预后不良和生活质量下降。与间接复位和前后螺钉固定相比，通过后外侧或后内侧入路进行切开复位和直接内固定越来越受到青睐。后内侧入路虽然精巧、直接，且能很好地暴露骨折部位，但使用频率低于后外侧入路。在本技术说明中，我们将逐步描述后内侧入路治疗后踝骨折的方法。我们还将讨论其适应症、优点和局限性。
