Pilon Frx: Fixation of Metaphysis to Diaphysis


- 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 in order to maintain the reduction;
    - references:
         - Hybrid external fixation in the treatment of the tibial plafond fractures.  
         - 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.  
         - External fixation of severely comminuted and open tibial pilon fractures.
         - Pilon Fractures: Treatment with Combined Internal and External Fixation.  
         - The small pin circular fixator for distal tibial pilon fractures with soft tissue compromise.  
         - Medial external fixation with lateral plate internal fixation in metaphyseal tibia fractures. A report of eight cases with severe soft-tissue injury.
         - Definitive plates overlapping provisional external fixator pin sites: is the infection risk increased?


- Butress Plating















Articulated external fixation of pilon fractures: the effects on ankle joint kinematics.

Two-staged delayed open reduction and internal fixation of severe pilon fractures.

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.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, March 17, 2015 11:12 am