Department of Orthopaedic Surgery, Boston Medical Center, Boston, MA.
J Orthop Trauma. 2022 Aug 1;36(Suppl 3):S25-S26. doi: 10.1097/BOT.0000000000002391.
We present the management of an OTA-43B Pilon fracture with a depressed plafond fragment, medial comminution, and displacement of the Chaput fragment. The patient was initially managed with external fixation to gain initial reduction of the pilon fracture and to allow the soft tissues to heal. As demonstrated, the extensile anterior approach can be modified and used to see the anteromedial and anterolateral tibial plafond so an anatomic reduction could be obtained. Also detailed is the reduction and fixation strategy and soft tissue closure, all of which plays a critical role in the outcome.
我们介绍了一例 OTA-43B 型 Pilon 骨折合并穹窿部凹陷骨折块、内侧粉碎和 Chaput 骨折块移位的治疗方法。患者最初采用外固定架治疗，以获得 Pilon 骨折的初步复位，并使软组织愈合。正如所展示的，可对伸展性前入路进行改良，用于观察胫骨前内侧面和前外侧面的穹窿部，以获得解剖复位。还详细介绍了复位和固定策略以及软组织的闭合，所有这些都对治疗结果起着至关重要的作用。
