Pilon Fractures

Mandi, Denise M.; Belin, Ron P.; Banks, Justin; Barrett, Brandon

doi:10.1016/j.cpm.2012.01.001

Cited by 21 publications

(19 citation statements)

References 66 publications

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“…They represent around 1% of all lower extremity fractures, and are more common in males between 35 and 40 years of age. 1 Such injuries may be caused by high- or low-energy mechanisms.…”

Section: Introductionmentioning

confidence: 99%

High-energy pilon fractures management

Tomàs-Hernández

2016

EFORT Open Reviews

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High-energy pilon fractures are challenging injuries. Multiple options are described for the definitive surgical management of these fractures, but there is no level I evidence for optimal management. The current management and recommendations for treatment will be reviewed in this article.Anatomical reduction of the fracture, restoration of joint congruence and reconstruction of the posterior column with a correct limb axis minimising the soft-tissue insult are the key points to a good outcome when treating pilon fractures.Even when these goals are achieved, there is no guarantee that results will be acceptable in the mid-term due to the frequent progression to post-traumatic arthritis.In high-energy fractures with soft-tissue compromise, a staged treatment is generally accepted as the best way to take care of these devastating fractures and is considered a local ‘damage control’ strategy.The axial cuts from the CT scan images are essential in order to define the location of the main fracture line, the fracture pattern (sagittal or coronal) and the number of fragments. All of this information is crucial for pre-operative planning, incision placement and articular surface reduction.No single method of fixation is ideal for all pilon fractures, or suitable for all patients. Definitive decision making is mostly dependent on the fracture pattern, condition of the soft-tissues, the patient’s profile and surgical expertise.Cite this article: Tomás-Hernández J. High-energy pilon fractures management: state of the art. EFORT Open Rev 2016;1:354-361. DOI: 10.1302/2058-5241.1.000016.

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“…They represent around 1% of all lower extremity fractures, and are more common in males between 35 and 40 years of age. 1 Such injuries may be caused by high- or low-energy mechanisms.…”

Section: Introductionmentioning

confidence: 99%

High-energy pilon fractures management

Tomàs-Hernández

2016

EFORT Open Reviews

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“…This term comes from the French word Bpestle^, and was used by anatomist and radiologist Étienne Destot [2]. He compared the anatomy of ankle joint to mortar and pestle, where the trochlea plays the role of a pestle, and the distal ends of tibia and fibula are mortar.…”

Section: Introductionmentioning

confidence: 99%

Comparison of different locking plate fixation methods in distal tibia fractures

Piątkowski

Piekarczyk

Kwiatkowski

et al. 2015

International Orthopaedics (SICOT)

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Purpose The aim of our study was to assess the outcome of locking plate fixation of distal tibia fractures and evaluate which surgical approach and method of plate fixation is related to better functional result and lower complication rate. Methods A retrospective analysis of treatment of 45 patients was made. Patients were divided into two subgroups regarding surgical approach (medial vs anterior) and fixation method (bridge plating vs rigid fixation). Time from injury to full bone union was noted, and clinical outcome was assessed by AOFAS score. Results Nonunion was the most prevalent complication and was observed in 26.6 % of patients. Infection rate was 11.1 %. Higher rate of bone union complications was noted in the anterior approach group with anterolateral anatomical plate. Infection and re-operation rates were similar in all subgroups. There were no correlations between fracture extension, length of plate and screw placement with bone healing time and AOFAS score. Conclusions Outcome of plate fixation of distal tibia fracture did not depend on the fixation method or surgical approach but, when possible, the medial plating via MIPO technique is a favourable method of treatment.

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“…Where is caused by trauma of high kinetic energy, where the metaphyseal-epiphyseal fragments impacted are solid metaphyseal. He is also known as axial compression and usually caused by trauma falling from great heights or traffic accident [5,6]. It is usually associated with severe soft tissue injuries associated with foot and ankle edema great causing bleeding from blisters, predisposing to infection [12].…”

Section: Discussionmentioning

confidence: 99%

“…The fall caused a physeal fracture of the fibula and left tibia with intra-articular involvement, (fractures of the tibial pilon, type III) [5], which is a relatively uncommon fracture therefore affects only 1% of the fracture of the lower limbs [6,7]. Following the classic protocol of this type of fracture, surgery was indicated immediately with the need to metallic syntheses.…”

Section: Case Studymentioning

confidence: 99%

Physical Therapy in the Pre and Post the Transtibial Amputation

Dorta¹

2015

Int J Phys Med Rehabil

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Patient, 62, male, suffered a fall in his residence and suffered a distal 1/3 intra-articular tibia fractures (type of tibial pilon fracture, Grade III), held a surgery for bone reconstruction with the need to use metallic synthesis, later came to develop osteomyelitis, achieve chronic and severe stage. He don`t responded to antibiotics, it was decided to perform the amputation member. From the time when the first operation after fracture and to make the second transtibial amputation, intense physical therapy for 06 weeks was carried out, with positive results in a short period of time, it appears that the treatment of pre amputation accelerates the process of prosthesis, gait, balance and therefore the return of their activities of daily living.

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Pilon Fractures

Cited by 21 publications

References 66 publications

High-energy pilon fractures management

High-energy pilon fractures management

Comparison of different locking plate fixation methods in distal tibia fractures

Physical Therapy in the Pre and Post the Transtibial Amputation

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