Orthopaedic and Trauma Unity, "M Bufalini" hospital, Cesena, Italy.
School of Medicine, University of Bari "Aldo Moro"- AOU Consorziale "Policlinico" - Department of Basic Medical Sciences, Neuroscience and Sense Organs; Orthopaedic & Trauma Unit, Bari, Italy.
J Biol Regul Homeost Agents. 2020 May-Jun;34(3 Suppl. 2):89-95. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS - SOTIMI 2019.
The treatment of posterior malleolus fractures has radically changed over the last few years, therefore this study aims to summarize the current evidence on the usefulness of posterior approaches in the management of malleolar fractures. The main elements that suggest the use of a posterior approach to the ankle are the posterior malleolus fragment shape and size, the presence of loose bodies at the fracture site: the possibility to obtain an anatomic fixation of the fracture; the presence of a posterior ankle subluxation; the eventually osteochondral impaction of the tibial plafond and the mechanical stability of the joint. The postero-lateral approach has been widely used to treat these fractures, but the posteromedial approach should be considered in specific cases. The anatomic reduction of these fractures lead to joint stability, with a consequent lesser occurrence of post-traumatic arthritis and better functional outcomes.
过去几年中，后踝骨折的治疗方法发生了重大变化，因此本研究旨在总结目前关于后入路在踝部骨折治疗中应用的有用性的证据。提示采用后踝入路的主要因素包括后踝骨块的形状和大小、骨折部位是否存在游离体：能否获得骨折的解剖固定；是否存在后踝半脱位；胫骨平台后关节面是否存在骨软骨嵌压以及关节的机械稳定性。后外侧入路已广泛用于治疗这些骨折，但在特定情况下应考虑后内侧入路。这些骨折的解剖复位可使关节稳定，从而减少创伤后关节炎的发生，获得更好的功能结果。
