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Pilon fractures of the distal tibia
P A Ruwe1, R L Randall, M R Baumgaertner
1Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut.
Orthopaedic Review
|September 1, 1993
Summary
Severe pilon fractures, tibial fractures affecting the ankle joint, are challenging. Open reduction and internal fixation significantly improve outcomes compared to traditional closed treatments.
Area of Science:
- Orthopaedic surgery
- Traumatology
Background:
- Pilon fractures are rare tibial fractures caused by axial/rotational forces.
- Severe injuries involve metaphyseal disruption, articular damage, and malleolar displacement.
- Traditional closed treatments yield unsatisfactory results for high-grade pilon fractures.
Purpose of the Study:
- To evaluate the effectiveness of open reduction and internal fixation (ORIF) for severe pilon fractures.
- To outline the surgical technique for ORIF of pilon fractures.
Main Methods:
- Anatomic restoration of fibular length.
- Reconstruction of the tibial plafond.
- Bone grafting for metaphyseal defects.
- Medial tibial buttress plating.
Main Results:
- Open reduction and internal fixation significantly improve outcomes.
- Meticulous surgical technique and preoperative planning are crucial.
- Predictably good results are achieved in most cases.
Conclusions:
- Open reduction and internal fixation is the preferred treatment for severe pilon fractures.
- Adherence to AO/ASIF principles ensures optimal surgical outcomes.
- This approach addresses the challenges posed by these complex fractures.