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- Discussion:
    - severe articular comminution and articular impaction frx;
    - reduce fibula then perform plate & lag screw fixation;
    - restores length of fractured distal tibia:
    - reduce articular surface
    - carried out & maintained by temporarily stabilizing it with K wires;
    - because of impaction of joint surface upward into metaphyseal cancellous bone, reconstruction of the joint surface is assoc w/
            producing a metaphyseal defect in the transitional bone between joint & shaft;
            - this must be filled in with a cancellous bone graft;
  - buttress plate:
            - addresses comminution in medial metaphyseal cortical bone,
            - function of this plate is to provide support to this weakened area and prevents varus deformity

           

The pilon map: fracture lines and comminution zones in OTA/AO type 43C3 pilon fractures.