tailieunhanh - Đặc điểm Gãy xương chày

Gãy xương chày plafond từ tải trục thương tích năng lượng cao với thiệt hại đáng kể liên quan đến mô mềm. Phương pháp phân loại mới bao gồm các subgroupings chi tiết giải phẫu và làm nổi bật các chấn thương mô mềm. | Tibial Plafond Fractures Changing Principles of Treatment Susan K. Bonar MD and J. L. Marsh MD Abstract Tibial plafond fractures from axial loading are high-energy injuries with significant associated soft-tissue damage. New classification methods include detailed anatomic subgroupings and highlight the soft-tissue injury. The traditional treatment of this intra-articular fracture with open reduction and internal fixation resulted in high rates of wound breakdown and infection. Treatment ofthese complications is lengthy and costly and not infrequently results in a poor outcome. Newer techniques using external fixation minimize disturbance of the soft-tissue envelope and have decreased these complications. Because the longterm outcome with all techniques is variable and often depends on factors beyond the surgeon s control it is particularly important to avoid complications of initial treatment. Longer follow-up will determine whether patients treated with these techniques have a different rate of arthrosis. J Am Acad Orthop Surg 1994 2 297-305 Intra-articular fractures of the distal tibia secondary to axial loading present a great challenge to the orthopaedic surgeon. These high-energy injuries often result in significant soft-tissue damage bone comminution and articular surface disruption. Until recently treatment has followed the AO principles of open reduction and internal fixation ORIF with plates and screws to permit early Recent publications however have called attention to the high rates of complications following such 3 For many of these fractures the risk of complications from ORIF outweighs the potential benefit. For these reasons the principles of tibial plafond fracture treatment are rapidly changing. Techniques utilizing external fixation are associated with satisfactory results and appear to significantly decrease the incidence of soft-tissue complications. Terminology The terms pilon fracture pylon fracture and plafond fracture .