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HENG Ke, TAO Tao, WEI Hui, ZHANG Yunkun, GENG Qinghe. Effects of different internal fixation methods combined approach in treatment of Klammer Ⅲ type posterior pilon fracture[J]. Journal of Clinical Medicine in Practice, 2021, 25(12): 66-69. DOI: 10.7619/jcmp.20210822
Citation: HENG Ke, TAO Tao, WEI Hui, ZHANG Yunkun, GENG Qinghe. Effects of different internal fixation methods combined approach in treatment of Klammer Ⅲ type posterior pilon fracture[J]. Journal of Clinical Medicine in Practice, 2021, 25(12): 66-69. DOI: 10.7619/jcmp.20210822
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Effects of different internal fixation methods combined approach in treatment of Klammer Ⅲ type posterior pilon fracture

  • 1.

    Department of Orthopedics, The Second People's Hospital of Changzhou Affiliated to Nanjing Medical University, Changzhou, Jiangsu, 213003

  • 2.

    Department of Orthopedics, Pizhou People's Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu, 221300

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  • Received Date: February 25, 2021
  • Available Online: July 04, 2021
  • Published Date: June 27, 2021
    Graphical Abstract
    • Abstract
  •   Objective  To investigate the clinical effect of different internal fixation methods combined approach in the treatment of Klammer Ⅲ type posterior pilon fracture.
      Methods  Twenty patients with Klammer Ⅲ type posterior pilon fractures were retrospectively analyzed. Among them, 9 cases underwent internal fixation with hollow nails (hollow nail group), and 11 cases underwent internal fixation with steel plate or steelplate plus hollow nails (steel plate group). After surgery, Visual Analogue Scale (VAS) and American Orthopedic Foot Andankle Society (AOFAS) ankle-hindfoot scale were used to evaluate the efficacy.
      Results  Fracture healing was observed in all 20 patients, and skin necrosis occurred in 1 case after surgery, which healed after dressing change for 1 month. There was no fracture nonunion, fracture and loosening of plate and screw after operation. Compared with the patients before surgery, the VAS scores of patients 3 and 6 months after surgery were significantly decreased, and the AOFAS scores were significantly increased (P < 0.05). The preoperative VAS score in the steel plate group was significantly higher than that of patients with hollow nail fixation (P < 0.05). The postoperative VAS scores in two groups were decreased, and the difference was not statistically significant (P>0.05). The AOFAS score in the steel plate group was significantly higher than that of patients with hollow nail fixation 3 months after surgery (P < 0.05). At 6 months after surgery, AOFAS scores in two groups were increased, and the difference was not statistically significant (P>0.05).
      Conclusion  Klammer Ⅲ type posterior pilon fracture with cannulated nail or steel plate fixation for fracture reduction is effective, and internal fixation combined with approach can fully expose the fracture end, and has better postoperative effect.
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    • References (14)
  • [1]
    CHAPARRO F, AHUMADA X, URBINA C, et al. Posterior pilon fracture: Epidemiology and surgical technique[J]. Injury, 2019, 50(12): 2312-2317. doi: 10.1016/j.injury.2019.10.007
    [2]
    KLAMMER G, KADAKIA A R, JOOS D A, et al. Posterior pilon fractures: a retrospective case series and proposed classification system[J]. Foot Ankle Int, 2013, 34(2): 189-199. doi: 10.1177/1071100712469334
    [3]
    TSCHERNE H, LOBENHOFFER P. Tibial plateau fractures[J]. Clin Orthop Relat Res, 1993, 292: 87-100. doi: 10.1097/00003086-199307000-00011
    [4]
    张宇, 孙海钰, 陈斌. 后外侧入路在后pilon骨折中的应用[J]. 实用骨科杂志, 2019, 25(5): 438-441. https://www.cnki.com.cn/Article/CJFDTOTAL-SGKZ201905014.htm
    [5]
    O'CONNOR T J, MUELLER B, LY T V, et al. "A to P" screw versus posterolateral plate for posterior malleolus fixation in trimalleolar ankle fractures[J]. J Orthop Trauma, 2015, 29(4): e151-e156. doi: 10.1097/BOT.0000000000000230
    [6]
    王旭, 耿翔, 张超, 等. 后pilon骨折Die-punch骨块的CT分型及应用[J]. 中华创伤骨科杂志, 2018, 20(6): 470-475. doi: 10.3760/cma.j.issn.1671-7600.2018.06.003
    [7]
    陈宇, 张晖, 刘熹, 等. 经改良后内侧入路联合支撑技术治疗关节面塌陷的后pilon骨折[J]. 中华医学杂志, 2019, 99(21): 1631-1635. doi: 10.3760/cma.j.issn.0376-2491.2019.21.008
    [8]
    MILLER M A, MCDONALD T C, GRAVES M L, et al. Stability of the syndesmosis after posterior malleolar fracture fixation[J]. Foot Ankle Int, 2018, 39(1): 99-104. doi: 10.1177/1071100717735839
    [9]
    JAYATILAKA M L T, PHILPOTT M D G, FISHER A, et al. Anatomy of the insertion of the posterior inferior tibiofibular ligament and the posterior malleolar fracture[J]. Foot Ankle Int, 2019, 40(11): 1319-1324. doi: 10.1177/1071100719865896
    [10]
    刘建, 邓志龙, 苟景跃, 等. Klammer分型对后pilon骨折手术的指导意义[J]. 创伤外科杂志, 2019, 21(9): 650-653. doi: 10.3969/j.issn.1009-4237.2019.09.003
    [11]
    MARTIN K D. Posterior arthroscopic reduction and internal fixation for treatment of posterior malleolus fractures[J]. Foot Ankle Int, 2020, 41(1): 115-120. doi: 10.1177/1071100719891978
    [12]
    GAO M, LIU N, CHENG Y, et al. Treatment outcomes of the posterolateral approach of plate fixation for posterior pilon fractures[J]. Exp Ther Med, 2019, 17(5): 4267-4272. http://www.ncbi.nlm.nih.gov/pubmed/31007756
    [12]
    WANG Y K, WANG J W, LUO C F. Modified posteromedial approach for treatment of posterior pilon variant fracture[J]. BMC Musculoskelet Disord, 2016, 17: 328. doi: 10.1186/s12891-016-1182-9
    [13]
    SUKUR E, AKMAN Y E, GOKCEN H B, et al. Open reduction in pilon variant posterior malleolar fractures: Radiological and clinical evaluation[J]. Orthop Traumatol Surg Res, 2017, 103(5): 703-707. doi: 10.1016/j.otsr.2017.05.012
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