fracture lines common to all pilon fractures, knowledge of which is vital for pre-operative planning, incision place-ment and articular reduction. The approach is selected based on fracture location and type. 2016 Apr;9(2):163-8. doi: 10.1177/1938640015620637. Historical Perspective The term ‘tibial pilon’ was first used by Destot in 1911, likening the pilon to a pestle. A posterior pilon fracture is a pilon variant that is a challenging injury to treat and can result in poor functional outcomes for patients. Internal fixation of the fracture and arthrodesis was performed using Among all Pilon … A, Anteromedial. Pilon fracture is a common fracture in trauma orthopedics and most of them are high-energy injury involving the distal tibial joint surface accompanied by fibular fractures and severe soft tissue injuries. Foot Ankle Spec . The purpose of this study is to evaluate a surgical strategy for pilon fractures based on ankle position/initial direction of fracture displacement at the time of injury. P. Yoon 10:56 Patrick Yoon External Fixation and Surgical Staging for Pilon Fractures 10:48 FORE 2018 Orthopaedics for the Primary Care Practitioner Feat. 6).Surgical procedure included wound 5 A, B) (12), with soft tissuelesions type IIIA (Fig. This video is a cadaveric dissection of the ankle showing first an anteromedial approach and then a posteromedial approach best used for pilon fractures. C, Posterolateral (fibula). Cross-sectional schematic showing the intervals for common approaches to pilon fractures. To explore the application and clinical efficacy of surgical approach strategies in open reduction internal fixation of closed complex tibial Pilon fractures based on axial CT scans. Wit … Omnidirectional Internal Fixation by Double Approaches for Treating Rüedi-Allgöwer Type III Pilon Fractures . Keywords: pilon fracture, plafond fracture, intra-articular ankle fractures, distal tibia fracture, AO/OTA 43A-C Introduction First described by French radiologist Destot in 1911, pilon fractures are defined as injuries that involve the articular weight-bearing surface of the distal tibia. [] in 2000, and later reported by Weber [], which is described as posterior malleolar fractures extending into posterior colliculus, indicating the presence of posteromedial (PM) fragment. Treatment of pilon fractures remains challenging due to the difficulty of fracture reduction and associated soft tissue complications. Methods Sixty-nine patients were categorized into groups based on ankle position at the time of the injury: Group I (varus), Group II (valgus), Group III (dorsiflexion), Group IV (plantarflexion), and Group V (neutral). Surgical Approaches (Fig. Both the pilon fracture and the lateral talar dome fracture were addressed simultaneously through a combination of the small anterolateral and anteromedial approaches. The aim of this study was to evaluate the pitfalls and strategies of posterior column reduction in the treatment of complex tibial pilon fractures (AO/OTA 43-C3). A Systematic Review of the Role of Surgical Approaches on the Outcomes of the Tibia Pilon Fracture. Keywords: Pilon fracture, Distal tibial fracture, Surgical approach, Surgical strategy, Introduction Tibial Pilon fractures are not common, accounting for only 5–7% of tibial fractures. DISCUSSION AND CONCLUSION: Knowledge of the multiple procedural variations for pilon fracture treatment creates the basis to optimize the treatment modalities and to take into account individual parameters of the fracture. pilon variant” as we adopted in this article, may indicate an independent fracture pattern, which requires special attention in surgical approach and appropriate fixation. 107 regarding a 59-year-old patient, victim of a fall from height accident and diagnosed with polytrauma and tibial pilon fracture type 43C3/AO (Fig. characterize fracture pattern, amount of comminution, metaphyseal bone loss, shortening, and angulation commonly 3 fragments according to ankle ligaments: medial malleolar (deltoid), anterolateral (AITFL, Chaput), and posterolateral (PITFL, Volkmann) fragments (OBQ11.6) A 34-year-old female sustains a pilon fracture after jumping from a ledge. He compared the talus to a pestle. Etienne Destot, a French Radiologist, is credited for using the term to describe the fracture in 1911. The pilon fracture components were reduced, and remaining articular cartilage from the ankle was removed. The axial compression force, torsion, and shear and bending from different angles constitute the basic mechanism of the pilon fracture (2) . 21-1) Figure 21-1. Usually, it is either anteromedial or Background/aim:Pilon fracture is difficult to treat fractures due to many complications that can develop after surgery. An anterolateral approach is used to obtain plate fixation as shown in Figure A. 11,12 The treatment effects Note fracture of the medial and lateral malleolus. Pilon is the French word for a pestle. For the reduction of pilon fractures with displaced central fragments and/or impaction, the exact approach is planned from the CT. Various surgical approaches to the ankle may be utilized depending on the location of the fracture fragments (anteromedial, direct anterior, anterolateral, posterolateral, posteromedial and direct medial). 2020 You do not currently have access to this content. Despite the … Methods Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. B, Anterolateral. A retrospective analysis was performed of 19 cases of Rüedi-Allgöwer type III unilateral closed pilon fracture. Pilon Fractures Philip Wolinsky University of California at Davis Medical Center Background Distal tibia fracture with intra-articular extension 1-10% of LE fx’s 20-25% are open 1/3 of patients have associated injuries Spectrum of AO Surgery Reference is a resource for the management of fractures, based on current clinical principles, practices and available evidence. Pilon fracture Other names Plafond fracture X-ray of a fracture involving the articular surface of the Tibia Specialty Orthopedic surgeryPilon is the French word for "pestle" and was introduced into orthopedic literature in 1911 by pioneer French radiologist Étienne Destot. Note that, in addition to the fracture of the medial and lateral malleolus, the plafond or weight-bearing area is fracture… B, Pilon fracture radiograph. Most pilon fractures are Tibial P ond laf Fractures (Pilon Fr act ur es) Muhammad Abdelghani 2. Unreconstructable Pilon Fractures: An Overview of Two Surgical Approaches and Their Outcomes Lauren Caradonna Southern Scholars Senior Project, March 2012 Southern Adventist University—Collegedale, TN Research Advisor In the early 20th century, “pilon fracture” was first used to explain the fracture of the distal tibia involving the articular surface by Étienne Destot . D, Posterolateral (tibia). 10.1055/b-0036-129629 Distal Tibia Fractures Sean E. Nork Fractures of the distal tibia are among the most difficult injuries facing the orthopaedic traumatologist. … The subchondral bone was drilled with a 2.0-mm drill. Posterior pilon, which has drawn attention over recent years, is considered as a variant of posterior malleolar fracture [1–15].The term was first given by Hansen et al. 39. tibial plafond (pilon) fractures 1. Approaches to Treating Pilon Fractures Feat. Pilon Fractures • Approaches & Technique – Beyond this scope – Anteromedial, anterolateral, posterior, anterior, perc, MIPO, percwith IMN, ringed fixation, etc. Liu J, Smith CD, White E, Ebraheim NA. P ond laf fractures ( pilon Fr act ur es ) Muhammad Abdelghani 2 performed 19... Tibia are among the most difficult injuries facing the orthopaedic traumatologist the most injuries. Iii unilateral closed pilon fracture and the lateral talar dome fracture were addressed simultaneously through a of. 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