Methods: A retrospective analysis in 14 patients with complex open pilon fractures treated between 2010 and 2015 was conducted. Tibial pilon fractures: a comparative clinical study of management techniques and results. In distal tibia the cleft tends to prefer the medial plafond at its connection with the medial malleolus. Trimalleolar fractures usually include a lateral malleolar fracture, a triangular fracture of the posterolateral corner of the tibial plafond, and a horizontal or oblique fracture of the medial malleolus. 1-5 Most studies that report outcomes after these fractures have assessed patients at a single point in time and report an average length of follow up. The lateral image shows lipohemarthrosis and a lateral tibial plateau fracture. Explanation. Aim: To report clinical and radiographic results of treatment of patients with complex open tibial pilon fractures. The injuries were graded according to AO Classification and the Gustillo-Anderson system. High-energy fractures are generally due to axial force that drives the talus into the tibial plafond, causing an “implosion” of the articular surface. Evolving treatment concepts for the pilon fracture. Type I: Intra-articular fracture of the distal tibia without significant displacement Type II: Intra-articular fracture of the distal tibia with significant displacement but minimal comminution Type III: Fracture of distal tibia with severe comminution and significant intra-articular displacement. ♦ Tibial plafond fractures demand respect, largely due to the fragile soft tissue envelope that surrounds the distal tibia♦ Careful preoperative planning followed by meticulous operative handling of the soft tissues is required to avoid devastating complications. Because of distracting injury and variations in clinical findings, tibial plafond fractures may be … Paris, France: Masson & Cie, 1949. Fractures of the tibial plafond, or distal tibial articular surface, are usually associated with a high-force mechanism, which frequently can involve associated injuries and prolonged disability. Female, 38 years old, with collapse fractures of the right tibial platform. Dillin L, Slabaugh P (1986) Delayed wound healing, infection, and nonunion following open reduction and internal fixation of tibial plafond fractures. Zeltzer DW, Leopold SS. This article addresses pilon fractures—a specific type of fracture that occurs in the lower leg near the ankle. 2.1 Intervention and outcome measurements. It is also known as Pilon fracture and explosion fracture. Schwartz DT. Classifications in Brief: Schatzker classification of tibial plateau fractures. In the most severe plafond fracture patterns, the articular segment is fractured into numerous pieces with certain segments driven proximally into the metaphysis, creating marked joint incongruity and associated metaphyseal defects. This is directly related to the special geometry of these fractures that have important transverse components. Salvage technique for treatment of periplafond tibial fractures: the modified fibula-pro-tibia procedure. PMID: 445923. Cleft tends to remain till the growth plate fuses. Pilon fractures are fractures of the distal tibial plafond. These fractures account for approximately 1% to 10% of the lower leg or tibial fractures and are often associated with severe bone comminution and soft tissue compromise. References: Danis R, ed. A pilon fracture (also called a tibial plafond fracture) is a comminuted fracture of the distal tibia involving the ankle joint. It involves the articular surface of the ankle joint. The pain had started gradually during a 10 mile running competition. Lateral knee X-ray with horizontal beam & AP image of the left knee. Schatzker J et al. Pilon Fractures or Tibial plafond fractures in their theory paper during university exams. (C) Preoperative magnetic resonance imaging (MRI) scan showing the lateral tibial plateau fracture and the complete disruption of the medial collateral ligment. Tibial Plateau Fracture. Unilateral external fixation for severe pilon fractures. To find in-depth information on ankle fractures, please read Ankle Fractures (Broken Ankle).. A pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint. Distal tibial triplane features, which constitute 6%-10% of epiphyseal injuries, are most accurately delineated and analyzed with computed tomography (CT). Emergency Radiology: Case Studies. Note the abnormal tibiofemoral alignment (> 5 mm). This patient had marked comminution as well as articular impaction of the distal tibial plafond. I. Overview. The tibial plateau fracture. The prevalence of osteochondritis dissecans in the tibial plafond detected on radiography is unknown. There may be slight spreading of either half of the epiphysis away from the cleft. It is also known as Pilon fracture and explosion fracture. Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. One hundred sixty-eight tibial plafond fractures were identified and included in the study . Reliability of Radiologic Assessment of the Fracture Anatomy at the Posterior Tibial Plafond in Malleolar Fractures April 2009 Journal of orthopaedic trauma 23(3):208-12 J Trauma 26(12): … Let Us Learn Orthopaedics- Tibial Plafond Fractures Pilon Fractures A Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. An insufficiency fracture of the tibial plateau may be the cause of knee pain in patients with osteoporosis. Fractures of the distal tibial plafond are also termed pilon fractures to describe the high energy axial compression force of the tibia as it acts as a pestle, driving vertically into the talus. Tibial Plafond Fractures is a topic covered in the 5-Minute Clinical Consult.. To view the entire topic, please sign in or purchase a subscription.. 5-Minute Clinical Consult (5MCC) app and website powered by Unbound Medicine helps you diagnose and manage 900+ medical conditions. Plafond fractures are also known as pilon fracture or explosion fracture anatomy. Clin Orthop Relat Res 1979; 138:94-104. Theorie et pratique de l’ osteosynthese. Subtle fractures may be missed in a knee X-ray. It involves the articular surface of the ankle joint. There are three possible explanations for the underreporting of this lesion in the radiology literature. Tibial Plafond Fractures - Trauma - Orthobullets Most articular fractures of the distal tibial weight-bearing surface are the result of motor vehicle accidents, motorcycle accidents, falls from heights, and industrial injuries. Tibial Fractures (Radiology (Mortise view: part of the 3 view series of…: Tibial Fractures (Radiology, Clinical presentation, Tibial Plateau fractures, Tibial shaft fractures, Tibial plafond fractures) New York: McGraw-Hill, 2008: 307-316. Patients with osteochondral lesions of the tibial plafond had similar symptoms as those with osteochondritis dissecans of the talar dome. The Toronto experience 1968–1975. Let Us Learn Orthopaedics- Tibial Plafond Fractures Pilon Fractures A Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. Outcomes after tibial plafond fractures are variable but typically they are not excellent. Classification. Fractures of the tibial plafond. Figure 1. The cause of Tibial Plafond Fracture is axial or rotational forces occurring from motor vehicle accidents or falling from a height. (A) Preoperative X-ray. A pilon fracture, is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint.Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents. A tibial plateau fracture is a common knee fracture. Unfortunately, clinical results with this technique were unreliable due to pathology (presumed arthrofibrosis) and technical problems (pooling of … Cleft of distal tibial epiphyses most closely resemble Salter-Harris III or IV fractures. It represents a wide spectrum of injury severity and accounts for approximately 5% to 7% of all tibia fractures and less than 1% of all lower-extremity fractures. Anterior tibial plafond fracture radiology. The cause of tibial plafond fracture is axial or rotational forces occurring from motor vehicle accidents or falling from a height. Tibial Plafond Fracture - TeachMe Orthopedics Tibial Plafond Fracture - TeachMe Orthopedics Thirty-six tibial plafond fractures were followed over two years, with thirty-one MDCTs being obtained four months after injury, and twenty-two MDCTs after two years. Data collected consisted of patient demographics, type of plafond fracture (AO/OTA 43-A, 43-B, 43-C), date of injury, date of last follow-up, progression to arthrodesis, and time from injury to arthrodesis. 1 Patients frequently have pain, impaired ankle function, and decreased general health status. Figure 20. A. Definition—Intraarticular fracture of the distal end of the tibia, also known as a tibial pilon fracture, involves disruption of the distal tibial weightbearing articular surface. It is also known as Pilon fracture and explosion fracture. (B) Preoperative computed tomography (CT) scan showing the lateral central collapse of the right tibial platform of ~2 cm. 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