- See:
Pilon Frx Menu:
- External Fixation:
- external fixation applied medially and across the ankle can protect the articular
reconstruction and prevent collapse;
- external fixation across the ankle can restore length (thru distraction) w/ or w/o
fibular fixation;
-
Technique of External Fixation
- 2-3 half pins are placed in the tibia;
-
foot inclusion;
- one pin is placed in the medial neck of the talus;
- in most cases, distraction of the talus will effect reduction of the fibula due to
their interconnecting ligaments;
- one pin is placed in the posterior calcaneus;
-
circular wire fixators
- distally, first wire is transfibular (posterolateral to anteromedial);
- second wire is inserted at the posteromedial edge of the distal tibia, and exits anterolaterally;
- additional pins are placed as is necessary;
- circular wire fixators need to include fixation and distraction across the talus inorder to effect reduction of the fibula;
- otherwise plate fixation of the fibula is required inorder to maintain the reduction;
- references:
- Hybrid external fixation in the treatment of the tibial plafond fractures. R Barbieri et al. CORR Vol 332. 1996. p 16-22.
-
Use of an articulated external fixator for fractures of the tibial plafond.
- Intra-articular fractures of the distal tibia: surgical management by limited internal fixation and articulated distraction. M Saleh et al. Injury. Vol 24. 1993. p 37-40.
-
External fixation of severely comminuted and open tibial pilon fractures.
- Pilon Fractures: Treatment with Combined Internal and External Fixation. P. Tornetta III et al. J. Orthop. Trauma. 1993. Vol 7. No 6. p 489-496.
- The small pin circular fixator for distal tibial pilon fractures with soft tissue compromise. CP Murphy et al. Orthopaedics. Vol 14. 1994. p 283-290.
-
Medial external fixation with lateral plate internal fixation in metaphyseal tibia fractures. A report of eight cases associated with severe soft-tissue injury.
- Butress Plating:
Articulated External Fixation of Pilon Fractures: The Effects on Ankle Joint Kenematics.
D.C. Fitzpatrick, J.L. Marsh, and T.D. Brown. J. Orthop. Trauma 1995. Vol 9, No 1, p 76-82.
Two staged delayed open reduction and internal fixation of severe pilon fractures.
MJ Patterson and JD Cole. Journal of Orthopaedic Trauma. Vol 13. No 2. p 85-91.
Early Limited Internal Fixation of Diaphyseal Extensions in Select Pilon Fractures: Upgrading AO/OTA Type C Fractures to AO/OTA Type B.
A prospective study evaluating incision placement and wound healing for tibial plafond fractures.
