Flores Michael, Ciminero Matthew, Kottmeier Stephen A, Botros Daniel, Zelle Boris A, Shearer David W
University of California, San Francisco, Department of Orthopaedic Surgery, San Francisco, CA.
Stony Brook University, Department of Orthopaedic Surgery, Stony Brook, NY; and.
OTA Int. 2023 Jun 16;6(3 Suppl):e236. doi: 10.1097/OI9.0000000000000236. eCollection 2023 Jun.
Pilon fractures are complex injuries that require an individualized approach to treatment to avoid complications and achieve good outcomes. Staged open reduction internal fixation remains the gold standard for most cases to achieve anatomic articular reduction while minimizing soft tissue complications and infection. Careful preoperative planning based on computed tomography dictates the surgical approach for reduction. A subset of cases may be amenable to early definitive or provisional open reduction and internal fixation based on fracture pattern. In some cases of severe articular comminution where reconstruction is not possible, primary ankle arthrodesis may be a good alternative.
Pilon骨折是复杂的损伤，需要个体化的治疗方法以避免并发症并取得良好的治疗效果。分期切开复位内固定术仍是大多数病例的金标准，可实现关节面解剖复位，同时将软组织并发症和感染降至最低。基于计算机断层扫描的仔细术前规划决定了复位的手术入路。根据骨折类型，一部分病例可能适合早期确定性或临时性切开复位内固定术。在一些严重关节粉碎无法重建的病例中，一期踝关节融合术可能是一个不错的选择。
