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经跟腱后向前方螺钉固定治疗后踝骨折：技术描述与病例系列

Percutaneous posterior to anterior screw fixation through achilles tendon for posterior malleolus fractures: technique description and case series.

作者信息

Dimitroulias Apostolos, Putur Danielle, Bogdan Yelena, Sen Milan K

机构信息

Department of Orthopedic Surgery, Jacobi Medical Center, Bronx, NY.

Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, NY.

出版信息

OTA Int. 2024 Mar 5;7(1):e321. doi: 10.1097/OI9.0000000000000321. eCollection 2024 Mar.

DOI:10.1097/OI9.0000000000000321
PMID:38449685
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10917136/
Abstract

Posterior malleolus fractures (PMFs) (OTA 43B1.1) are frequently seen in combination with fractures of the fibula, medial malleolus, and distal tibia; they can rarely be seen in isolation. PMFs affect the alignment of the ankle mortise and the stability of syndesmosis. Techniques described for fixation of PMFs include open reduction internal fixation through a posterolateral or posteromedial approach or anterior-to-posterior screw fixation. For selected minimally displaced or nondisplaced fractures of the posterior malleolus, we developed a percutaneous technique through the Achilles tendon for the insertion of a posterior-to-anterior cannulated screw. The technique is described, and a clinical series is reviewed.

摘要

后踝骨折（PMFs）（OTA 43B1.1）常与腓骨、内踝和胫骨远端骨折合并出现；单独出现的情况较为罕见。PMFs会影响踝关节榫眼的对线及下胫腓联合的稳定性。描述的用于固定PMFs的技术包括通过后外侧或后内侧入路切开复位内固定或前后向螺钉固定。对于部分后踝的轻微移位或无移位骨折，我们开发了一种经跟腱的经皮技术来插入后向前空心螺钉。本文描述了该技术，并回顾了一组临床病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/24fdaca0c96c/oi9-7-e321-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/2be3856c5d49/oi9-7-e321-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/832b0f849cc4/oi9-7-e321-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/845538198c21/oi9-7-e321-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/3fff2437a173/oi9-7-e321-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/24fdaca0c96c/oi9-7-e321-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/2be3856c5d49/oi9-7-e321-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/832b0f849cc4/oi9-7-e321-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/845538198c21/oi9-7-e321-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/3fff2437a173/oi9-7-e321-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5050/10917136/24fdaca0c96c/oi9-7-e321-g005.jpg

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Trans-Achilles percutaneous fixation technique for posterior malleolus fracture: a cadaveric study.经跟腱皮外固定技术治疗后踝骨折：尸体研究。
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本文引用的文献

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2
Anatomic Analysis of a Percutaneous Fixation Technique for the Posterior Malleolus Using Posterior-to-Anterior-Directed Cannulated Screws: A Cadaveric Study and Technique Description.使用后向前导向空心螺钉治疗后踝的经皮固定技术的解剖学分析：一项尸体研究及技术描述
J Am Acad Orthop Surg Glob Res Rev. 2021 Feb 18;5(2):01979360-202102000-00008. doi: 10.5435/JAAOSGlobal-D-20-00215.
3
Comparison of the efficacy of posterior-anterior screws, anterior-posterior screws and a posterior-anterior plate in the fixation of posterior malleolar fractures with a fragment size of ≥ 15 and < 15.
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BMC Musculoskelet Disord. 2020 Aug 22;21(1):570. doi: 10.1186/s12891-020-03594-7.
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Anatomic Structures at Risk During Posterior to Anterior Percutaneous Screw Fixation of Posterior Malleolar Fractures: A Cadaveric Study.后前经皮螺钉固定后踝骨折时的风险解剖结构：尸体研究。
Foot Ankle Spec. 2022 Feb;15(1):50-58. doi: 10.1177/1938640020943004. Epub 2020 Jul 22.
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Morphology of the Posterior Malleolar Fracture Associated With a Spiral Distal Tibia Fracture.后踝骨折的形态与胫骨远端螺旋骨折相关。
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