REDINTEGRATION OF ARTICULAR SURFACE AND ALIGNMENT WITH TIBIA TYPE III Pilon FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Hongjun , CAO Xiaoming , WANG Jie , YANG Chunlei.

Department of Orthopaedics, the Third Affiliated Hospital of Jianghan University, Wuhan Hubei, 430300, P.R.China. Corresponding author: LI Hongjun, E-mail: lihongjun7172@163.com;

Corresponding author：

Keywords：

Type III Pilon fracture; Articular surface; Limb alignment; Repair and reconstruction

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore an improved method of surgical operation for redintegration of the articular surface and alignment with type III Pilon fractures. Methods Between August 2005 and August 2010, 31 patiens with closed type III Pilon fracture (Rüedi-Allg ouml;wer type III) were treated. There were 25 males and 6 females, aged 36.8 years on average (range, 16-60 years). The injury was caused by falling from height in 18 patients, by traffic accident in 10 patients, and by other reasons in 3 patients. The average time between injury and operation was 10 days (range, 6-14 days). Temporary external fixation was used for adjustment and maintenance of limb length and power lines; application of fibular flip combined with anteromedial approach was used for the repair of articular surface; and bone grafting and fixation were performed. Results No extensive necrosis or deep infection were observed. Superficial skin infection of incision and wound edge necrosis occurred in 2 cases respectively, and were cured after dressing change. All patients were followed up 26 months on average (range, 9-79 months). According to the Burwell et al. judging standards of radiology evaluating, the anatomical reduction was found in 25 cases (80.6%), satisfactory reduction in 4 cases (12.9%), and unsatisfactory reduction in 2 cases (6.5%). The X-ray films showed bony healing was achieved in all cases with an average fracture healing time of 16 weeks (range, 12-25 weeks). According to the Mazur et al. criterion for ankle joint function, excellent result was obtained in 11 cases, good in 13, fair in 5, and poor in 2; the excellent and good rate was 77.4%. Conclusion Good exposure and fixation of articular surface or accurate adjustments and maintenance of the limb alignment are key factors of successful operation to treat type III Pilon fractures.

Citation： LI Hongjun,CAO Xiaoming,WANG Jie,YANG Chunlei.. REDINTEGRATION OF ARTICULAR SURFACE AND ALIGNMENT WITH TIBIA TYPE III Pilon FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(8): 926-929. doi: Copy

1.	张波, 黄雷, 王满宜, 等. 胫骨Pilon骨折的手术治疗. 中华骨科杂志, 2001, 21(7): 403-407.
2.	段戡, 姚弘毅, 袁长深, 等. Pilon骨折手术治疗的国外进展. 中国矫形外科杂志, 2008, 16(22): 1730-1732.
3.	顾立强. Pilon骨折的分类与功能评价. 中华创伤骨科杂志, 2004, 6(8): 894-898.
4.	赵天云, 刘新成, 赵溪林, 等. Pilon Ⅲ型骨折的关节面修复重建. 中国修复重建外科杂志, 2007, 21(10): 1036-1039.
5.	任继鑫, 刘智, 李京生, 等. 复杂Pilon骨折治疗方法的选择. 中华创伤骨科杂志, 2005, 7(3): 221-224.
6.	Burwell HN, Charnley AD. The treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement. J Bone Joint Surg (Br), 1965, 47(4): 634-660.
7.	Mazur JM, Schwartz E, Simon SR. Ankle arthrodesis: long-term follow-up with gait analysis. J Bone Joint Surg (Am), 1979, 61(7): 964-975.
8.	王谦, 王秋根. Pilon骨折的手术治疗. 国际骨科学杂志, 2008, 29(2): 110-112.
9.	俞光荣, 汪文. Pilon 骨折的治疗方法的选择和疗效评价. 中华骨科杂志, 2007, 27(2): 149-154.
10.	Rüedi TP, Allgüwer M. Fractures of the lower end of the tibia into the ankle joint. Injury, 1969, 1: 92-99.
11.	Waddell JP. Tibia plafond fractures//Tacherne H, Schatzker J, eds. Major fractures of the Pilon, the talus, and the calcaneus. Heidelberg: Springer-Verlag, 1993: 43-48.
12.	汤欣, 吕德成, 唐佩福, 等. Pilon骨折的解剖四柱理论与临床治疗的关系. 中华外科杂志, 2010, 48(9): 662-666.
13.	蔡锦方, 邹林, 王平山. 带关节的超关节外固定架结合有限内固定治疗Pilon骨折. 中华创伤骨科杂志, 2005, 7(12): 1132-1135.
14.	黄雷, 张峰, 叶鹏翰, 等. 分阶段延期切开复位内固定治疗严重Pilon骨折. 中华创伤骨科杂志, 2009, 11(11): 1039-1041.
15.	杨小海, 吕建元, 张征石, 等. 分期手术微创锁定加压钢板治疗高能量Pilon骨折. 中国修复重建外科杂志, 2011, 25(11): 1402-1404.
16.	Babis GC, Vayanos ED, Papaioannou N, et al. Results of surgical treatment of tibial plafond fractures. Clin Orthop Relat Res, 1997, (341) : 99-100.
17.	杨正明, 潘志军, 李杭, 等. 胫骨Pilon骨折的外科治疗策略. 中华创伤杂志, 2010, 26(9): 835-839.
18.	肖睿, 唐强, 蔡程, 等. 有限内固定结合外固定支架治疗Pilon骨折. 中国修复重建外科杂志, 2005, 19(8): 603-606.
19.	邹拥军, 张帆, 于凯, 等. 锁定加压钢板微创治疗 Pilon 骨折. 中国修复重建外科杂志, 2010, 24(10): 1271-1272.
20.	黄开, 杨金华, 张剑平. 有限内固定结合外固定支具及骨牵引治疗高能量 Pilon 骨折. 中国修复重建外科杂志, 2010, 24(5): 628-629.

1. 张波, 黄雷, 王满宜, 等. 胫骨Pilon骨折的手术治疗. 中华骨科杂志, 2001, 21(7): 403-407.
2. 段戡, 姚弘毅, 袁长深, 等. Pilon骨折手术治疗的国外进展. 中国矫形外科杂志, 2008, 16(22): 1730-1732.
3. 顾立强. Pilon骨折的分类与功能评价. 中华创伤骨科杂志, 2004, 6(8): 894-898.
4. 赵天云, 刘新成, 赵溪林, 等. Pilon Ⅲ型骨折的关节面修复重建. 中国修复重建外科杂志, 2007, 21(10): 1036-1039.
5. 任继鑫, 刘智, 李京生, 等. 复杂Pilon骨折治疗方法的选择. 中华创伤骨科杂志, 2005, 7(3): 221-224.
6. Burwell HN, Charnley AD. The treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement. J Bone Joint Surg (Br), 1965, 47(4): 634-660.
7. Mazur JM, Schwartz E, Simon SR. Ankle arthrodesis: long-term follow-up with gait analysis. J Bone Joint Surg (Am), 1979, 61(7): 964-975.
8. 王谦, 王秋根. Pilon骨折的手术治疗. 国际骨科学杂志, 2008, 29(2): 110-112.
9. 俞光荣, 汪文. Pilon 骨折的治疗方法的选择和疗效评价. 中华骨科杂志, 2007, 27(2): 149-154.
10. Rüedi TP, Allgüwer M. Fractures of the lower end of the tibia into the ankle joint. Injury, 1969, 1: 92-99.
11. Waddell JP. Tibia plafond fractures//Tacherne H, Schatzker J, eds. Major fractures of the Pilon, the talus, and the calcaneus. Heidelberg: Springer-Verlag, 1993: 43-48.
12. 汤欣, 吕德成, 唐佩福, 等. Pilon骨折的解剖四柱理论与临床治疗的关系. 中华外科杂志, 2010, 48(9): 662-666.
13. 蔡锦方, 邹林, 王平山. 带关节的超关节外固定架结合有限内固定治疗Pilon骨折. 中华创伤骨科杂志, 2005, 7(12): 1132-1135.
14. 黄雷, 张峰, 叶鹏翰, 等. 分阶段延期切开复位内固定治疗严重Pilon骨折. 中华创伤骨科杂志, 2009, 11(11): 1039-1041.
15. 杨小海, 吕建元, 张征石, 等. 分期手术微创锁定加压钢板治疗高能量Pilon骨折. 中国修复重建外科杂志, 2011, 25(11): 1402-1404.
16. Babis GC, Vayanos ED, Papaioannou N, et al. Results of surgical treatment of tibial plafond fractures. Clin Orthop Relat Res, 1997, (341) : 99-100.
17. 杨正明, 潘志军, 李杭, 等. 胫骨Pilon骨折的外科治疗策略. 中华创伤杂志, 2010, 26(9): 835-839.
18. 肖睿, 唐强, 蔡程, 等. 有限内固定结合外固定支架治疗Pilon骨折. 中国修复重建外科杂志, 2005, 19(8): 603-606.
19. 邹拥军, 张帆, 于凯, 等. 锁定加压钢板微创治疗 Pilon 骨折. 中国修复重建外科杂志, 2010, 24(10): 1271-1272.
20. 黄开, 杨金华, 张剑平. 有限内固定结合外固定支具及骨牵引治疗高能量 Pilon 骨折. 中国修复重建外科杂志, 2010, 24(5): 628-629.

Chinese Journal of Reparative and Reconstructive Surgery

REDINTEGRATION OF ARTICULAR SURFACE AND ALIGNMENT WITH TIBIA TYPE III Pilon FRACTURE

Abstract Full text Figures/Tables Video References Cited by

Format

Content