后Pilon骨折及关节面夹层骨块诊疗进展

后Pilon骨折是由压缩暴力伴或不伴有旋转暴力引起的胫骨远端关节面骨折，其影像学特点为后踝骨折线沿胫骨远端冠状面延伸至内踝后丘，多合并踝关节后脱位、外踝骨折和软骨损伤。目前各研究者对于后Pilon骨折手术入路、复位顺序及内固定方式仍持有不同观点，尤其对关节面夹层骨块的处理是当前临床治疗的争论焦点。本文根据现有文献对后Pilon骨折的诊断分型、手术方式，尤其是关节面夹层骨块的显露和处理，以及相应的术后疗效作一综述。

Recent advances in diagnosis and treatment of posterior pilon fractures and intercalary fragment

Posterior pilon fracture is a type of fracture with the involvement of the entire posterior tibial plafond caused by vertical compression force with or without torsional force. The imaging feature is that the fracture line of the posterior malleolus extended along the coronal plane of the distal tibia to the posterior colliculus of the medial malleolus. Besides, posterior pilon fractures were often associated posterior dislocation of the ankle joint, fracture of the lateral malleolus and cartilage injury. At present, researchers still hold different views on the surgical approach, reduction sequence and internal fixation of posterior pilon fracture, especially on the treatment of intercalary fragment. According to the literature, the diagnosis, classification, surgical technique and the prognosis of posterior pilon fracture, especially how to deal with the intercalary fragment were reviewed.