11,12 The treatment effects Despite the … Liu J, Smith CD, White E, Ebraheim NA. 6).Surgical procedure included wound B, Anterolateral. … To explore the application and clinical efficacy of surgical approach strategies in open reduction internal fixation of closed complex tibial Pilon fractures based on axial CT scans. (OBQ11.6) A 34-year-old female sustains a pilon fracture after jumping from a ledge. Tibial P ond laf Fractures (Pilon Fr act ur es) Muhammad Abdelghani 2. Treatment of pilon fractures remains challenging due to the difficulty of fracture reduction and associated soft tissue complications. Methods Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. pilon variant” as we adopted in this article, may indicate an independent fracture pattern, which requires special attention in surgical approach and appropriate fixation. For the reduction of pilon fractures with displaced central fragments and/or impaction, the exact approach is planned from the CT. A posterior pilon fracture is a pilon variant that is a challenging injury to treat and can result in poor functional outcomes for patients. An anterolateral approach is used to obtain plate fixation as shown in Figure A. Posterior pilon, which has drawn attention over recent years, is considered as a variant of posterior malleolar fracture [1–15].The term was first given by Hansen et al. [] in 2000, and later reported by Weber [], which is described as posterior malleolar fractures extending into posterior colliculus, indicating the presence of posteromedial (PM) fragment. Pilon fracture is a common fracture in trauma orthopedics and most of them are high-energy injury involving the distal tibial joint surface accompanied by fibular fractures and severe soft tissue injuries. The axial compression force, torsion, and shear and bending from different angles constitute the basic mechanism of the pilon fracture (2) . Pilon Fractures Philip Wolinsky University of California at Davis Medical Center Background Distal tibia fracture with intra-articular extension 1-10% of LE fx’s 20-25% are open 1/3 of patients have associated injuries Spectrum of 2020 You do not currently have access to this content. Internal fixation of the fracture and arthrodesis was performed using DISCUSSION AND CONCLUSION: Knowledge of the multiple procedural variations for pilon fracture treatment creates the basis to optimize the treatment modalities and to take into account individual parameters of the fracture. characterize fracture pattern, amount of comminution, metaphyseal bone loss, shortening, and angulation commonly 3 fragments according to ankle ligaments: medial malleolar (deltoid), anterolateral (AITFL, Chaput), and posterolateral (PITFL, Volkmann) fragments AO Surgery Reference is a resource for the management of fractures, based on current clinical principles, practices and available evidence. Note that, in addition to the fracture of the medial and lateral malleolus, the plafond or weight-bearing area is fracture… Historical Perspective The term ‘tibial pilon’ was first used by Destot in 1911, likening the pilon to a pestle. Cross-sectional schematic showing the intervals for common approaches to pilon fractures. D, Posterolateral (tibia). 107 regarding a 59-year-old patient, victim of a fall from height accident and diagnosed with polytrauma and tibial pilon fracture type 43C3/AO (Fig. Note fracture of the medial and lateral malleolus. 5 A, B) (12), with soft tissuelesions type IIIA (Fig. The aim of this study was to evaluate the pitfalls and strategies of posterior column reduction in the treatment of complex tibial pilon fractures (AO/OTA 43-C3). B, Pilon fracture radiograph. 10.1055/b-0036-129629 Distal Tibia Fractures Sean E. Nork Fractures of the distal tibia are among the most difficult injuries facing the orthopaedic traumatologist. Etienne Destot, a French Radiologist, is credited for using the term to describe the fracture in 1911. The approach is selected based on fracture location and type. The subchondral bone was drilled with a 2.0-mm drill. Pilon Fractures • Approaches & Technique – Beyond this scope – Anteromedial, anterolateral, posterior, anterior, perc, MIPO, percwith IMN, ringed fixation, etc. fracture lines common to all pilon fractures, knowledge of which is vital for pre-operative planning, incision place-ment and articular reduction. Various surgical approaches to the ankle may be utilized depending on the location of the fracture fragments (anteromedial, direct anterior, anterolateral, posterolateral, posteromedial and direct medial). 21-1) Figure 21-1. Background/aim:Pilon fracture is difficult to treat fractures due to many complications that can develop after surgery. The pilon fracture components were reduced, and remaining articular cartilage from the ankle was removed. Approaches to Treating Pilon Fractures Feat. Most pilon fractures are In the early 20th century, “pilon fracture” was first used to explain the fracture of the distal tibia involving the articular surface by Étienne Destot . Methods Sixty-nine patients were categorized into groups based on ankle position at the time of the injury: Group I (varus), Group II (valgus), Group III (dorsiflexion), Group IV (plantarflexion), and Group V (neutral). Wit … Omnidirectional Internal Fixation by Double Approaches for Treating Rüedi-Allgöwer Type III Pilon Fractures . Among all Pilon … This video is a cadaveric dissection of the ankle showing first an anteromedial approach and then a posteromedial approach best used for pilon fractures. Pilon is the French word for a pestle. A, Anteromedial. C, Posterolateral (fibula). Keywords: pilon fracture, plafond fracture, intra-articular ankle fractures, distal tibia fracture, AO/OTA 43A-C Introduction First described by French radiologist Destot in 1911, pilon fractures are defined as injuries that involve the articular weight-bearing surface of the distal tibia. Foot Ankle Spec . Surgical Approaches (Fig. Keywords: Pilon fracture, Distal tibial fracture, Surgical approach, Surgical strategy, Introduction Tibial Pilon fractures are not common, accounting for only 5–7% of tibial fractures. The purpose of this study is to evaluate a surgical strategy for pilon fractures based on ankle position/initial direction of fracture displacement at the time of injury. A Systematic Review of the Role of Surgical Approaches on the Outcomes of the Tibia Pilon Fracture. Unreconstructable Pilon Fractures: An Overview of Two Surgical Approaches and Their Outcomes Lauren Caradonna Southern Scholars Senior Project, March 2012 Southern Adventist University—Collegedale, TN Research Advisor A retrospective analysis was performed of 19 cases of Rüedi-Allgöwer type III unilateral closed pilon fracture. He compared the talus to a pestle. 2016 Apr;9(2):163-8. doi: 10.1177/1938640015620637. Usually, it is either anteromedial or Pilon fracture Other names Plafond fracture X-ray of a fracture involving the articular surface of the Tibia Specialty Orthopedic surgeryPilon is the French word for "pestle" and was introduced into orthopedic literature in 1911 by pioneer French radiologist Étienne Destot. 39. tibial plafond (pilon) fractures 1. Both the pilon fracture and the lateral talar dome fracture were addressed simultaneously through a combination of the small anterolateral and anteromedial approaches. P. Yoon 10:56 Patrick Yoon External Fixation and Surgical Staging for Pilon Fractures 10:48 FORE 2018 Orthopaedics for the Primary Care Practitioner Feat. , the exact approach is selected based on current clinical principles, and. 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