Pilon骨折多元化分析与诊疗进展

Multivariate Analysis of Pilon Fractures and Progress in Diagnosis and Treatment

摘要: Pilon骨折或胫骨远端爆裂骨折，均用来描述胫骨远端的关节内骨折。从低能量的旋转暴力引起的骨折到由车祸或高处坠落所产生的高能量轴向压缩暴力引起骨折。高能量所致的骨折常为开放性损伤，或伴有严重的软组织闭合性创伤。骨折可有明显的干骺端或关节面粉碎，或向骨干延伸。为选择理想的治疗方案和评估预后，对这些骨折进行分类非常重要。目前对于Pilon骨折的分型以及手术时间的选择、何种固定方式尚未达成统一的认识。本篇对Pilon骨折的损伤机制，骨折分型和手术时机、手术方式选择方面的研究进展进行综述，为临床治疗Pilon骨折提供临床参考。

Abstract: Pilon fractures or distal tibial blowout fractures are used to describe intra-articular fractures of the distal tibia. From fractures caused by low-energy rotational violence to fractures caused by high-energy axial compression violence caused by a car accident or a fall from a height, fractures caused by high energy are often open injuries or accompanied by severe soft tissue closed trauma. The fracture may be marked by metaphyseal or articular surface comminution, or by extension to the shaft. It is important to classify these fractures in order to select the ideal treatment and assess prognosis. At present, there is no consensus on the classification of Pilon fracture, the choice of op-eration time and the fixation method. This review reviews the research progress in injury mecha-nism, fracture classification, operation timing and operation mode selection of Pilon fractures, and provides clinical reference for the clinical treatment of Pilon fractures.