Pilon-tibiale-Frakturen

Abstract

Because of the complex fracture morphology and vulnerable soft tissue coverage, fractures of the tibial pilon are difficult to treat. Complications are more common than in bi- or trimalleolar fractures. The surgeon has to know about the special risks of these injuries to avoid complications. Early complications are soft tissue necrosis, persisting fragment dislocations after surgery, loss of reposition and deep wound infection. The surgeon has to be aware of early signs of compartment-syndrome and chronic regional pain syndrome (CRPS). In late complications such as bony necrosis with or without deviation, non-union and osteoarthrosis of the ankle joint give the surgeon more time for planning the therapy. Intensive monitoring until bone healing is necessary in tibial pilon fractures to detect complications early and start the therapy immediately. This kind of therapy results in the best outcome for these patients.

Treatment Algorithm for Pilon Fracture - Clinical and Radiological Results

“…In order to counteract these risk factors and to reduce complications that define the outcome of these severe injuries, clearly defined surgical principles and stan-dardized treatment protocols are needed (7,15). During the initial management of pilon tibial fractures the closed reduction and external fixation is in most cases the first step of treatment, as the fractures are too unstable and the soft-tissues are compromised for retention in plaster (18).…”

Закритий Малоінвазивний Остеосинтез Епіметафізарних Переломів Дистального Відділу Кісток Гомілки

“…При такому доступі додаткова травматизація м'яких тканин мінімальна. Постеромедіальний і/або постеролатеральний доступ R. Gaulke et al [9] рекомендують застосовувати при лікуванні тих досить рідкісних переломів пілона, які відбуваються під спільним впливом обертального й осьового навантаження. На думку J. Hong et al [10], постеромедіальний доступ адекватний завданню лікування перелому пілона, особливо в тих випадках, коли серйозно пошкоджені м'які тканини.…”

Tactical treatment optimization for long bone distal metaepiphysis fractures based on biological principles

“…However, this process also had negative consequences. Primarily, it concerns a threatening number of complications which reach 54 % at some localizations of intra-articular and near-articular fractures (Pilon fractures) [5][6][7][8][9][10][11][12][13][14]. This circumstance determines the relevance of this study.…”