Gao Yanchun, Zhu Hongyi, Guo Yanjie, Yu Xingang
Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.
J Pers Med. 2023 Mar 20;13(3):551. doi: 10.3390/jpm13030551.
Staged treatment for pilon fractures is widely accepted. It remains to be discussed how to reduce and fix posterior column fractures while avoiding clinical complications. We provided a staged treatment protocol with detailed surgical techniques for closed AO Foundation/Orthopaedic Trauma Association (AO/OTA) C3 tibial pilon fractures with fibular fractures. In the first stage, the internal fixation of the fibula and distal tibial posterior column is accompanied by an external fixator. After swelling, the medial and anterior columns were fixed via the posteromedial approach in the second stage. We advocate early reduction and fixation of the posterior column and lateral column. The right timing of surgery can ensure well-reduced articular surface and alignment while minimizing soft tissue complications.
Pilon骨折的分期治疗已被广泛接受。如何在避免临床并发症的同时复位和固定后柱骨折仍有待探讨。我们提供了一种分期治疗方案，其中包含针对伴有腓骨骨折的闭合性AO基金会/骨创伤协会（AO/OTA）C3型胫骨Pilon骨折的详细手术技术。第一阶段，在应用外固定架的同时对腓骨和胫骨远端后柱进行内固定。肿胀消退后，在第二阶段经后内侧入路对内侧柱和前侧柱进行固定。我们主张早期复位并固定后柱和外侧柱。恰当的手术时机可确保关节面良好复位和对线，同时将软组织并发症降至最低。
