Ayeni J P
Coventry and Warwickshire Hospital.
Injury. 1988 Mar;19(2):109-14. doi: 10.1016/0020-1383(88)90085-x.
Twenty-seven pilon fractures of the tibia were identified from 733 adult tibial and ankle fractures admitted to the Coventry and Warwickshire Hospital in 5 years. Nineteen of the 27 were reviewed. The fractures were classified into types I, II and III according to the AO/ASIF system. Treatment was by splintage in plaster-of-Paris or open reduction and internal fixation, and an external fixator for one type III. Non-operative treatment produced good functional results in all type I fractures, poor results in type II and was not applicable to type III. Eight of 11 types II and III fractures, treated by internal fixation achieved good functional results. Hindfoot disability was assessed from subtalar movements. It is concluded that open reduction and internal fixation is indicated in types II and III pilon fractures. Subtalar motion is negligibly restricted in type I fractures, while in types II and III internal fixation is followed by recovery of hindfoot function.
在考文垂和沃里克郡医院5年间收治的733例成人胫骨和踝关节骨折中，确诊了27例胫骨pilon骨折。对这27例中的19例进行了回顾性研究。根据AO/ASIF系统，将骨折分为I型、II型和III型。治疗方法为石膏夹板固定或切开复位内固定，1例III型骨折采用外固定架固定。非手术治疗对所有I型骨折均取得了良好的功能效果，对II型骨折效果较差，对III型骨折不适用。11例II型和III型骨折中，8例行切开复位内固定后取得了良好的功能效果。通过距下关节活动评估后足功能障碍情况。结论是，II型和III型pilon骨折需行切开复位内固定。I型骨折距下关节活动受限可忽略不计，而II型和III型骨折切开复位内固定后后足功能可恢复。
