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Intraarticular "pilon" fracture of the tibia
D L Helfet1, K Koval, J Pappas
1Orthopaedic Trauma Service, Tampa General Hospital, Florida.
Clinical Orthopaedics and Related Research
|January 1, 1994
Summary
This study reviews tibial pilon fracture management, detailing surgical techniques for complex cases. Open reduction and internal fixation yielded high union rates, though functional outcomes varied by fracture type.
Area of Science:
- Orthopedic Surgery
- Trauma Management
Background:
- Tibial pilon fractures are severe injuries often resulting from high-energy trauma.
- Management requires careful classification and surgical planning for optimal outcomes.
Purpose of the Study:
- To review classification and treatment options for tibial pilon fractures.
- To describe surgical techniques for open reduction and internal fixation (ORIF) in comminuted and displaced fractures.
- To evaluate the outcomes and complications of ORIF for tibial pilon fractures.
Main Methods:
- Retrospective review of 34 tibial pilon fractures in 32 patients treated between 1984 and 1989.
- Classification based on Rüedi-Allgöwer system (Type II and Type III).
- Treatment included external fixation or ORIF; surgical techniques for ORIF were detailed.
Main Results:
- 88% of fractures united by 16 weeks; 2 delayed unions, 1 amputation, 1 plate breakage occurred.
- In Rüedi-Allgöwer Type II fractures, 65% had excellent and 23% had poor functional results.
- In Rüedi-Allgöwer Type III fractures, 50% had excellent and 37% had poor functional results.
- Complications included superficial and deep wound infections in open fractures.
Conclusions:
- ORIF is a viable treatment for tibial pilon fractures, achieving high union rates.
- Functional outcomes are better in Type II than Type III fractures.
- Careful surgical technique and management of open fractures are crucial to minimize complications.