Treatment Algorithm for Pilon Fracture - Clinical and Radiological Results

Abstract

PŮVODNÍ PRÁCEfinitive treatment with open reduction and internal fixation was regarded as safe (4,10,26,33), there has been a worldwide shift over the last years towards a staged treatment protocol of these complex fractures with widely accepted principles, like the respect of the soft-tissues, or the necessity of a CT-scan before the definitive treatment (15,17,22,31,37). Despite the fact that the main points of the operative treatment strategy of Ruedi and Allgöwer remain still the same (osteosynthesis of the fibula, reduction of the articular surface, bone grafting for the metaphyseal INTRODUCTIONPilon tibial fractures are characterized in most cases by complex fracture patterns and severe soft-tissue injuries (22). Both require a differentiated treatment algorithm, in order to prevent complications and to succeed a good outcome. Pilon tibial fractures set often a challenge for the treating surgical team and require meticulous analysis and thorough planning, in order to be able to minimize the complications and the risk for postoperative ankle arthritis (15,22,28). While in the early days of the surgical treatment of pilon tibial fractures the primary de-