胫骨远端骨折的治疗策略及研究进展

Treatment Strategies and Research Progress of Distal Tibial Fractures

摘要: 随着创伤骨科诊疗理念的不断发展，胫骨远端骨折的治疗策略及相关研究取得了较大进展。由于胫骨远端解剖结构复杂、邻近踝关节且软组织条件较差，其治疗需在恢复骨折稳定性的同时兼顾软组织保护及踝关节功能重建。本文系统综述了胫骨远端骨折的诊疗策略及研究进展。影像学与生物力学研究为骨折分型、术前评估和治疗决策提供了依据。不同手术策略的固定方式各有特点，其中微创技术在保护软组织和减少并发症方面具有一定优势。规范化围手术期管理、并发症早期监测以及新型植入材料、个体化器械和数字化辅助技术的发展，也为精准治疗提供了新的思路。总体而言，个体化、微创化和精准化已成为胫骨远端骨折治疗的重要发展方向，但仍需更多高质量研究为临床决策提供依据。

Abstract: With the continuous advancement of trauma orthopedic concepts, considerable progress has been achieved in the treatment strategies and related research of distal tibial fractures. Because of the complex anatomy of the distal tibia, its proximity to the ankle joint, and the poor surrounding soft-tissue conditions, treatment should restore fracture stability while preserving soft tissue and reconstructing ankle function. This review systematically summarizes the treatment strategies and research progress of distal tibial fractures. Imaging and biomechanical studies provide important support for fracture classification, preoperative assessment, and therapeutic decision-making. Different fixation methods have distinct characteristics, and minimally invasive techniques show certain advantages in soft-tissue protection and complication reduction. Meanwhile, standardized perioperative management, early monitoring of complications, and the development of novel implant materials, individualized instruments, and digital-assisted technologies have also provided new insights for precision treatment. In general, individualized, minimally invasive, and precise treatment has become an important trend in the management of distal tibial fractures, although more high-quality studies are still required to support clinical decision-making.