Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 999, Xiwang Road, Jiading District, Shanghai, China.
Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 999, Xiwang Road, Jiading District, Shanghai, China.
Foot Ankle Clin. 2022 Mar;27(1):73-90. doi: 10.1016/j.fcl.2021.11.005. Epub 2022 Jan 31.
Management of posttraumatic ankle arthritis due to tibial plafond fracture is technically demanding. The distal tibial plafond-plasty could be an alternative to preserve the ankle joint for young patients with limited ankle arthritis. The surgical principles are to realign the mechanical axis, reconstruct the articular surface of the distal tibial plafond, and achieve a congruent and stable ankle joint. In addition to the anteroposterior view of the ankle joint, the lateral view was also paramount for surgeons to fully evaluate the reduction quality. The revision procedures are as follows: osteotomy for exposure, articular surface reconstruction, bone grafting, and osteotomy fixation.
治疗创伤后距骨骨折引起的踝关节关节炎具有一定的技术难度。对于踝关节关节炎局限且年轻的患者，可选择胫骨远端平台成形术来保留踝关节。手术的原则是纠正力线，重建胫骨远端关节面，使踝关节达到匹配和稳定。除了踝关节的正位片，侧位片对于术者全面评估复位质量也至关重要。翻修手术步骤如下：切开暴露、关节面重建、植骨和截骨固定。
