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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.