Intraarticular "pilon" fracture of the tibia. ³

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Helfet DL. Koval K. Pappas J. Sanders RW. DiPasquale T. Clinical Orthopaedics & Related Research. (298):221-8, 1994 Jan. Classification and treatment options for the management of tibial pilon fractures are reviewed. For comminuted and/or displaced fractures that require open reduction and internal fixation, a detailed description of the surgical technique, including indirect reduction techniques, is provided. Thirty-four pilon fractures (32 patients) treated during a Á period of five years (1984-1989) were reviewed. All were high-energy  injuries (15 patients with multiple trauma) with Ruedi-Allgower Type II in 26 and Type III in eight. Eighteen (56%) were open fractures. Six fractures were treated with external fixation and the remaining 28 with open reduction and internal fixation. The patient follow-up examination period averaged 16.2 months (range, six to 38 months). Thirty (88%) fractures had united by 16 weeks (two delayed unions, one below knee amputation, and one plate breakage). In the 26 Type II fractures, functional grading found 17 excellent (65%) and six (23%) poor results. In the eight Type III fractures, there were four (50%) excellent and three (37%) poor results. Complications included one superficial pin-tract infection and two deep wound infections, both in Grade II open fractures.