The posterior Pilon fracture: treatment and results via a posterolateral approach  

作　　者：黄若昆[1] 谢鸣[1] 方真华[1] 肖志宏[1] 赵晶晶[1] 李静[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院足踝外科,中国武汉430033

出　　处：《中国矫形外科杂志》2014年第8期673-677,共5页Orthopedic Journal of China

摘　　要：[Objective]This study was designed to describe the fracture patterns and early results of operations of posterior Pilon fractures through a posterolateral approach.[Method]This study consisted of 14 cases,10 males and 4 females with the mean age of 47 years(range,28-63 years).The causes were traffic accident in 2,falling in 6 and sprain injuries in 6 cases.The duration from injury to operation was 7-14 days.Including 12 cases combined with distal fibula fracture and3 cases with medial malleolus fracture.There were 3 posterior dislocation fracture.All cases were treated with open reduction and internal fixation(ORIF).[Result]A consistent fracture pattern was identified with a primary,inferiorly posterior Pilon fracture that likely occur through a combined rotational and axial load mechanism.The average duration of follow-up was 26(range,24-37)months.The postoperation average of American Orthopedic Foot Ankle Society score(AOFAS)was 92points which was much higher than before operation.Anatomical reduction were obtained in all cases.Two complications(1wound superficial infection and 1 sural cutaneous nerve injury)were all managed nonoperatively.[Conclusion]Posterior Pilon fractures form a consistent pattern.They can be successfully managed through a posterolateral approach with direct reduction and buttress fixation of articular fragments.[ Objective] This study was designed to describe the fracture patterns and early results of operations of poste- rior Pilon fractures through a posterolateral approach. [ Method ] This study consisted of 14 cases, 10 males and 4 females with the mean age of 47 years （range, 28 -63 years）. The causes were traffic accident in 2, falling in 6 and sprain injuries in 6 cases. The duration from injury to operation was 7 - 14 days. Including 12 cases combined with distal fibula fracture and 3 cases with medial malleolus fracture. There were 3 posterior dislocation fracture. All cases were treated with open reduction and internal fixation （ORIF）. [ Result] A consistent fracture pattern was identified with a primary, inferiorly posterior Pilon fracture that likely occur through a combin^d rotational and axial load mechanism. The average duration of follow - up was 26 （range, 24- 37） months. The postoperation average of American Orthopedic Foot Ankle Society score （AOFAS） was 92 points which was much higher than before operation. Anatomical reduction were obtained in all cases. Two complications （ 1 wound superficial infection and 1 sural cutaneous nerve injury） were all managed nonoperatively. [ Conclusion] Posterior Pi- Ion fractures form a consistent pattern. They can be successfully managed through a posterolateral approach with direct reduc- tion and buttress fixation of articular fragments.

关 键 词：后外侧入路 后Pilon骨折 内固定 

分 类 号：R687.3[医药卫生—骨科学]