Analysis of the efficacy of a modified posteromedial approach for Klammer III posterior Pilon fractures

作     者：Zheng-Chao Zhang Wu-Bing He Hao Lin 

作者机构：Department of Emergency SurgeryFujian Provincial HospitalFuzhou350001China Provincial Clinical Medical College of Fujian Medical UniversityFuzhou350001China 

出 版 物：《Chinese Journal of Traumatology》 (中华创伤杂志（英文版）)

年 卷 期：2022年第25卷第2期

页      面：83-89页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Posterior pilon fracture Klammer III type Modified posteromedial approach 

摘      要：Purpose:To analyze the curative effect and technical points of a modified posteromedial approach in the treatment of Klammer III posterior Pilon ***:A retrospective analysis of patients with Klammer III posterior Pilon fractures were conducted in our department from January 2018 to December *** the surgery,the patients were fully relieved of swelling and pain,and a comprehensive examination was carried *** posteromedial approach exposed the posterior and medial fracture block of the distal *** to the fracture of external malleolus,it is determined whether to combine a lateral incision and protect tendons and vascular nerves by a retractor,and then perform a fracture reduction and internal ***,the patients were treated with analgesia,detumescence,anticoagulation and rehabilitation *** American orthopaedic foot and ankle society(AOFAS)score and visual analogue score were recorded at regular follow-up after surgery.A t-test was used for the comparison of the preoperative and final AOFAS ***:There were 7 male and 13 female(n=20)included in the study,aged 22 to 88 years(average age 54.2 years).The injury mechanisms were falling from a height(n=7),traffic accident(n=6),walking injury(n=2)and heavy injury(n=5).The postoperative follow-up duration was 12—24 months(mean 16.95 months).The AOFAS score of the 20 patients before and after surgery were *** preoperative AOFAS score was 38.90±3.91,and the final AOFAS score was 80.55±4.20,(p0.001).The mean final visual analogue scores at rest,active and weight-bearing walking were 0.30,0.85 and 1.70,*** patient reported poor postoperative wound healing and required a return to hospital for debridement and anti-infection ***:In the treatment of Klammer III posterior Pilon fractures,the modified posteromedial approach can fully expose the fracture block and the collapsed articular surface of the medial malleolus,achieve