milmedВоенная медицинаMilitary Medicine2074-5044Белорусский государственный медицинский университетmilmed-841Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESВнутрисуставные переломы дистального отдела большеберцовой кости – современные концепции леченияIntraarticular fractures of the distal tibia – current managementСитникА. А.SitnikA. А.ГУ «Республиканский научно-практический центр травматологии и ортопедии»Belarus20202710202602132140Copyright © Ситник А.А., 20262026Ситник А.А.Sitnik A.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://milmed.ejournal.by/jour/article/view/841

Результаты лечения внутрисуставных переломов дистального отдела голени значительно улучшились в последние два десятилетия. Понимание роли мягких тканей привело к разработке стратегии этапного лечения данных повреждений. Сначала применяется мостовидная внешняя фиксация, которая обеспечивает восстановление длины сегмента, частичную репозицию перелома за счет лигаментотаксиса и относительную стабильность костных фрагментов, необходимую для восстановления мягких тканей. Окончательное хирургическое лечение выполняется в отсроченном порядке при нормализации состояния мягких тканей и после выполнения тщательного предоперационного планирования, основанного на углубленном изучении морфологии перелома с помощью КТ. Осознанный выбор хирургического доступа для реконструкции суставной поверхности, щадящее, атравматичное обращение с мягкими тканями и применение современных малоинвазивных методов фиксации метафизарной области обеспечивают оптимальные условия для сращения перелома и восстановления функции конечности.

Results of the treatment of intraarticular fractures of the distal tibia have improved significantly during last two decades. Better understanding of the role of soft tissues has led to the development of a staged treatment strategy of these injuries. Initial application of external fixation provides the restoration of the length of the limb, partial fracture reduction through ligamentotaxis and relatively stable position of the fracture fragments, that is important for the healing of soft tissues. Definitive surgical treatment is delayed until the condition of soft tissues becomes safe. During this time thorough preoperative planning is performed on the base of detailed study of the fracture morphology with CT-scanning. Sophisticated choice of the surgical approach(-es), atraumatic soft tissue handling and the use of modern fixation techniques for the metaphyseal component provide optimal conditions the fracture union and restoration of the limb function.

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The authors declare that there are no conflicts of interest present.