Gaulke Ralph, Krettek Christian
Sektion Obere Extremität, Fuß- und Rheumachirurgie, Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Hannover, Deutschland.
Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Unfallchirurg. 2017 Aug;120(8):658-666. doi: 10.1007/s00113-017-0366-6.
Because of the complex fracture morphology and vulnerable soft tissue coverage, fractures of the tibial pilon are difficult to treat. Complications are more common than in bi- or trimalleolar fractures. The surgeon has to know about the special risks of these injuries to avoid complications. Early complications are soft tissue necrosis, persisting fragment dislocations after surgery, loss of reposition and deep wound infection. The surgeon has to be aware of early signs of compartment-syndrome and chronic regional pain syndrome (CRPS). In late complications such as bony necrosis with or without deviation, non-union and osteoarthrosis of the ankle joint give the surgeon more time for planning the therapy. Intensive monitoring until bone healing is necessary in tibial pilon fractures to detect complications early and start the therapy immediately. This kind of therapy results in the best outcome for these patients.
由于胫骨平台骨折的骨折形态复杂且软组织覆盖易受损，此类骨折难以治疗。其并发症比双踝或三踝骨折更为常见。外科医生必须了解这些损伤的特殊风险以避免并发症。早期并发症包括软组织坏死、术后骨折块持续脱位、复位丢失及深部伤口感染。外科医生必须意识到骨筋膜室综合征和慢性区域疼痛综合征（CRPS）的早期迹象。在晚期并发症中，如伴有或不伴有畸形的骨坏死、骨不连和踝关节骨关节炎，给外科医生更多时间来规划治疗方案。对于胫骨平台骨折，在骨愈合前进行密切监测以早期发现并发症并立即开始治疗是必要的。这种治疗方式能为这些患者带来最佳治疗效果。
