{"title":"Die Defektpseudarthrose des Pilon tibiale: Möglichkeiten der Defektrekonstruktion und Endoprothetik","authors":"Serafeim Tsitsilonis , Dominik Adl Amini , Tobias Gehlen","doi":"10.1016/j.fuspru.2024.03.001","DOIUrl":null,"url":null,"abstract":"<div><p>The operative treatment of tibial pilon fracture is a surgical challenge, especially the treatment of its complications. Among them, a non-union with bone loss at the ankle joint is a major complication and high surgical expertise is needed due to its complexity. Besides the option of a fusion, nowadays the option of a total ankle replacement (TAR) is also available. The meticulous analysis of the reasons that lead to the non-union and bone defect, the identification of the individual demands of each patient, as well as the biological and biomechanical characteristics of the micro-environment of the bone are prerequisites for the planning of a personalized treatment of the severe complication. The present paper focuses on the reasons that can lead to a non-union with defect after surgical treatment of tibial pilon fractures, as well as on the available treatment options in the form of either an ankle fusion or TAR.</p></div>","PeriodicalId":39776,"journal":{"name":"Fuss und Sprunggelenk","volume":"22 1","pages":"Pages 50-59"},"PeriodicalIF":0.0000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1619998724000102/pdfft?md5=3c3aa66626885ccb2e44d484bc44730c&pid=1-s2.0-S1619998724000102-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Fuss und Sprunggelenk","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1619998724000102","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
The operative treatment of tibial pilon fracture is a surgical challenge, especially the treatment of its complications. Among them, a non-union with bone loss at the ankle joint is a major complication and high surgical expertise is needed due to its complexity. Besides the option of a fusion, nowadays the option of a total ankle replacement (TAR) is also available. The meticulous analysis of the reasons that lead to the non-union and bone defect, the identification of the individual demands of each patient, as well as the biological and biomechanical characteristics of the micro-environment of the bone are prerequisites for the planning of a personalized treatment of the severe complication. The present paper focuses on the reasons that can lead to a non-union with defect after surgical treatment of tibial pilon fractures, as well as on the available treatment options in the form of either an ankle fusion or TAR.
胫骨皮隆骨折的手术治疗是一项外科挑战,尤其是并发症的治疗。其中,踝关节处骨缺损导致的不愈合是主要并发症,由于其复杂性,需要高超的手术技巧。除了融合术,如今还可以选择全踝关节置换术(TAR)。对导致骨不愈合和骨缺损的原因进行细致分析,确定每位患者的个体需求,以及骨微环境的生物和生物力学特征,是针对这一严重并发症制定个性化治疗方案的先决条件。本文重点介绍了胫骨皮隆骨折手术治疗后可能导致不愈合和骨缺损的原因,以及踝关节融合术或 TAR 的可用治疗方案。