Bone L B
Orthop Clin North Am. 1987 Jan;18(1):95-104.
The fracture of the tibial plafond or pilon fracture is an uncommon but difficult fracture to manage. Fracture of the plafond occurs when the talus is driven into the tibia from axial compression. The type of fracture that occurs will depend on the position and rotation of the foot at the time of impact. Historically, these fractures have been treated in a number of manners, but the best results have occurred when stable internal fixation is accomplished using plates and screws. Basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect, and buttress plating either anteriorly or medially of the distal tibia. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, early motion of the ankle is made possible. This early motion reduces stiffness of the ankle and will yield the most satisfying results.
胫骨平台骨折或pilon骨折是一种少见但处理起来较为棘手的骨折。当距骨因轴向压缩而嵌入胫骨时，就会发生平台骨折。所发生的骨折类型将取决于受伤时足部的位置和旋转情况。从历史上看，这些骨折有多种治疗方式，但当使用钢板和螺钉实现稳定的内固定时，效果最佳。重建的基本步骤包括用钢板固定恢复腓骨的解剖长度、重建胫骨关节面、对干骺端缺损处进行松质骨移植，以及在胫骨远端前方或内侧进行支撑钢板固定。如果能够恢复关节面的解剖重建并实现稳定固定，踝关节的早期活动就成为可能。这种早期活动可减轻踝关节的僵硬程度，并产生最令人满意的效果。
