Chau Ming Hong, Liu Stephanie Ka Ki
Department of O&T, Princess Margaret Hospital (HKSAR), Kwai Chung, Hong Kong.
Arthrosc Tech. 2025 Apr 15;14(6):103530. doi: 10.1016/j.eats.2025.103530. eCollection 2025 Jun.
Ankle fractures comprise up to 10% of fracture cases in adults. Ankle fractures frequently require surgical treatment to prevent posttraumatic osteoarthritis in the future. One of the most complex patterns is the pilon type of ankle fracture. It is commonly associated with high complication rates. When the foot is in a neutral position, a pure compression force leads to a central depression type of tibial plafond fracture. Traditionally, it is managed by open reduction and internal fixation, which requires large incisions and more soft-tissue dissection. The central depression is difficult to approach with traditional open surgery, especially when the anterior tibial cortex is intact. Further extension of surgical wound may be needed to tackle the distal tibial shaft fracture as well. With recent development on minimally invasive technique, this fracture can be successfully managed with an arthroscopic approach using multiple stab incisions. In this Technical Note, we present a full percutaneous approach to manage this type of injury using jail screw technique with arthroscopy.
踝关节骨折占成人骨折病例的10%。踝关节骨折常需手术治疗以预防未来创伤后骨关节炎。最复杂的骨折类型之一是pilon型踝关节骨折，其通常伴有高并发症发生率。当足部处于中立位时，单纯压缩力会导致胫骨平台中央凹陷型骨折。传统上，采用切开复位内固定治疗，这需要大切口和更多的软组织剥离。传统开放手术难以处理中央凹陷，尤其是当胫骨前缘皮质完整时。若要处理胫骨干远端骨折，可能还需要进一步延长手术切口。随着微创技术的最新发展，这种骨折可以通过使用多个小切口的关节镜手术成功治疗。在本技术说明中，我们介绍一种使用关节镜下“锁定螺钉”技术全经皮治疗此类损伤的方法。
