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同侧Pilon骨折合并跟骨骨折的治疗：1例罕见病例报告

Management of Ipsilateral Pilon with Calcaneal Fractures: A Rare Case Report.

作者信息

Yadav Siddhart, Chiranjeevi K P, Jadon Akash Singh, Bedwal Dharm, Pandey Sameer

机构信息

Department of Orthopaedics, Apollo Hospital, Sector 23, CBD Belapur, Navi Mumbai, Maharashtra, India.

出版信息

J Orthop Case Rep. 2025 Jun;15(6):102-106. doi: 10.13107/jocr.2025.v15.i06.5680.

DOI:10.13107/jocr.2025.v15.i06.5680
PMID:40520735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12159640/
Abstract

INTRODUCTION

Ipsilateral pilon and calcaneal fractures are quite rare. Tibial pilon fractures are uncommon, <1% of all fractures to the lower extremity. Calcaneum is the most frequently fractured tarsal bone.

CASE REPORT

This is a case report of a 33-year-old male presented on April 21, 2023 in Apollo Hospital, Navi Mumbai with ipsilateral pilon and calcaneal fracture with L2 burst fracture with cauda equina syndrome.

RESULT

The patient was treated D12-L4 Stabilization with dural repair on April 22, 2023 and was operated on April 28 with internal fixation with plates and screws for pilon and calcaneum .patient was followed up for a period of 1 year postoperatively.

DISCUSSION

Open reduction and internal fixation of displaced calcaneal fractures and pilon fractures by locking plate to maintain the height and joint congruity. Surgery for pilon fractures fixation should be delayed, ideally till "wrinkling of the skin" occurs.

CONCLUSION

Based on our study, we conclude that a delayed single-stage open reduction and internal fixation with locking plate for calcaneum and pilon fracture with iliac crest bone graft is an excellent treatment option with good post-operative outcome and no significant complications. Axial loading due to a fall from height is the most common mode in these types of injuries.

摘要

引言

同侧的Pilon骨折和跟骨骨折相当罕见。胫骨Pilon骨折并不常见，占下肢所有骨折的比例不到1%。跟骨是跗骨中最常发生骨折的骨头。

病例报告

这是一例病例报告，一名33岁男性于2023年4月21日就诊于孟买新港区的阿波罗医院，患有同侧Pilon骨折和跟骨骨折，同时伴有L2爆裂骨折并马尾综合征。

结果

患者于2023年4月22日接受了D12 - L4稳定术及硬脊膜修复，于4月28日接受手术，采用钢板和螺钉对Pilon骨折和跟骨骨折进行内固定。术后对患者进行了为期1年的随访。

讨论

对于移位的跟骨骨折和Pilon骨折，采用锁定钢板进行切开复位内固定以维持高度和关节一致性。Pilon骨折固定手术应推迟，理想情况下直到出现“皮肤起皱”。

结论

基于我们的研究，我们得出结论，对于跟骨和Pilon骨折采用延迟一期切开复位内固定并植髂骨，使用锁定钢板是一种极佳的治疗选择，术后效果良好且无明显并发症。高处坠落导致的轴向负荷是这类损伤最常见的方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6183/12159640/ec63c99e5592/JOCR-15-102-g010.jpg
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