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경골 Pilon 골절의 AO/ ASIF 식 수술적 치료
김기용,빈성일,오원혁 대한골절학회 1992 대한골절학회지 Vol.5 No.1
The intra-articular fractures of the distal tibia extending into the ankle joint, the so called tibial pilon fractures, present a challenge to the surgeon because of their severity of comminution and impaction. They usually result from vertical compression forces and rotational forces which lead to a force directed through the talus into the tibial plafond. Although historically the results of various type of treatment of these fractures have been less than optimal, there has been a recent trend that suggests success in the majority of cases through operative treatment following the principles outlined by the AO/ASIF group; (1) Reconstruction of the correct length of the fibula; (2) Reconstruction of the articular surface of the tibia; (3) Introduction of a cancellous autograft to fill in the bone defect in the metaphysis of the tibia; (4) Stabilization of the medial aspect of the tibia by a plate, and then early range of motion exercises of ankle joint and delayed weight bearing. The results of treatment of 8 cases tibial pilon fractures exciusively treated by internal fixation following the principles of the AO/ASIF group were analysed at the Department of Orthopedic Surgery, Asan Medical Center from Oct. 1989 to Jun. 1991. The results were as follows: 1. The major cause of injury was fall down (6 out of 8 cases). 2. The assocated injuries were fractures of calcaneus (2), talus (2), vertebra(1), pat.ella(1), tarsal bones (1) anrl midtarsal joint dislocation (1). 3. The ipsilateral fibular fractures were combined in 5 out of 8 cases. 4. The types of fractures were type B (3 cases), type C (5 cases) according to AO/ASIF classification. 5. Open reduction and internal fixation was performed with cloverleaf plate (5 cases) and May anatomical bane plate (3 cases). 6. The good results were 5 cases and fair results were 3 cases.