Saleh M, Shanahan M D, Fern E D
Department of Orthopaedic Surgery, Northern General Hospital, Sheffield, UK.
Injury. 1993;24(1):37-40. doi: 10.1016/0020-1383(93)90081-g.
A series of 12 patients with severe intra-articular (pilon) fractures of the distal tibia were treated by open reduction and internal fixation of the principal articular fragments. Tibial length was restored and maintained by an articulated external fixator which allowed early mobilization of the joint, and associated fibular fractures were fixed internally. Of the patients, nine have been followed up for an average of 33 months (range 18-60 months); three are still undergoing active treatment. Results have been assessed using the scoring system devised by Karlsson and Peterson. Four patients had scores > 80, four had scores between 50 and 79, and one had a score < 50. This technique is less invasive than conventional open procedures that require the use of a tibial plate and may be of particular value in the management of open fractures.
对12例严重的胫骨干骺端关节内（pilon）骨折患者进行了主要关节面骨折块的切开复位内固定治疗。通过可活动的外固定器恢复并维持胫骨长度，该外固定器可使关节早期活动，同时对合并的腓骨骨折进行内固定。其中9例患者接受了平均33个月（范围18 - 60个月）的随访；3例仍在接受积极治疗。采用Karlsson和Peterson设计的评分系统对结果进行评估。4例患者评分>80分，4例患者评分在50至79分之间，1例患者评分<50分。该技术比需要使用胫骨钢板的传统切开手术侵入性小，在开放性骨折的治疗中可能具有特殊价值。
