characterize fracture pattern, amount of comminution, metaphyseal bone loss, shortening, and angulation commonly 3 fragments according to ankle ligaments: medial malleolar (deltoid), anterolateral (AITFL, Chaput), and posterolateral (PITFL, Volkmann) fragments The approach is selected based on fracture location and type. Treatment of pilon fractures remains challenging due to the difficulty of fracture reduction and associated soft tissue complications. To explore the application and clinical efficacy of surgical approach strategies in open reduction internal fixation of closed complex tibial Pilon fractures based on axial CT scans. D, Posterolateral (tibia). Pilon Fractures • Approaches & Technique – Beyond this scope – Anteromedial, anterolateral, posterior, anterior, perc, MIPO, percwith IMN, ringed fixation, etc. … The axial compression force, torsion, and shear and bending from different angles constitute the basic mechanism of the pilon fracture (2) . Most pilon fractures are 2020 You do not currently have access to this content. Liu J, Smith CD, White E, Ebraheim NA. Usually, it is either anteromedial or 21-1) Figure 21-1.  in 2000, and later reported by Weber , which is described as posterior malleolar fractures extending into posterior colliculus, indicating the presence of posteromedial (PM) fragment. For the reduction of pilon fractures with displaced central fragments and/or impaction, the exact approach is planned from the CT. The purpose of this study is to evaluate a surgical strategy for pilon fractures based on ankle position/initial direction of fracture displacement at the time of injury. 11,12 The treatment effects Pilon fracture is a common fracture in trauma orthopedics and most of them are high-energy injury involving the distal tibial joint surface accompanied by fibular fractures and severe soft tissue injuries. Note that, in addition to the fracture of the medial and lateral malleolus, the plafond or weight-bearing area is fracture… Unreconstructable Pilon Fractures: An Overview of Two Surgical Approaches and Their Outcomes Lauren Caradonna Southern Scholars Senior Project, March 2012 Southern Adventist University—Collegedale, TN Research Advisor In the early 20th century, “pilon fracture” was first used to explain the fracture of the distal tibia involving the articular surface by Étienne Destot . Etienne Destot, a French Radiologist, is credited for using the term to describe the fracture in 1911. 107 regarding a 59-year-old patient, victim of a fall from height accident and diagnosed with polytrauma and tibial pilon fracture type 43C3/AO (Fig. DISCUSSION AND CONCLUSION: Knowledge of the multiple procedural variations for pilon fracture treatment creates the basis to optimize the treatment modalities and to take into account individual parameters of the fracture. Pilon is the French word for a pestle. pilon variant” as we adopted in this article, may indicate an independent fracture pattern, which requires special attention in surgical approach and appropriate fixation. The subchondral bone was drilled with a 2.0-mm drill. AO Surgery Reference is a resource for the management of fractures, based on current clinical principles, practices and available evidence. B, Anterolateral. Posterior pilon, which has drawn attention over recent years, is considered as a variant of posterior malleolar fracture [1–15].The term was first given by Hansen et al. Keywords: Pilon fracture, Distal tibial fracture, Surgical approach, Surgical strategy, Introduction Tibial Pilon fractures are not common, accounting for only 5–7% of tibial fractures. 10.1055/b-0036-129629 Distal Tibia Fractures Sean E. Nork Fractures of the distal tibia are among the most difficult injuries facing the orthopaedic traumatologist. fracture lines common to all pilon fractures, knowledge of which is vital for pre-operative planning, incision place-ment and articular reduction. Note fracture of the medial and lateral malleolus. Methods Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. Various surgical approaches to the ankle may be utilized depending on the location of the fracture fragments (anteromedial, direct anterior, anterolateral, posterolateral, posteromedial and direct medial). Wit … Omnidirectional Internal Fixation by Double Approaches for Treating Rüedi-Allgöwer Type III Pilon Fractures . Historical Perspective The term ‘tibial pilon’ was first used by Destot in 1911, likening the pilon to a pestle. Pilon fracture Other names Plafond fracture X-ray of a fracture involving the articular surface of the Tibia Specialty Orthopedic surgeryPilon is the French word for "pestle" and was introduced into orthopedic literature in 1911 by pioneer French radiologist Étienne Destot. P. Yoon 10:56 Patrick Yoon External Fixation and Surgical Staging for Pilon Fractures 10:48 FORE 2018 Orthopaedics for the Primary Care Practitioner Feat. (OBQ11.6) A 34-year-old female sustains a pilon fracture after jumping from a ledge. Tibial P ond laf Fractures (Pilon Fr act ur es) Muhammad Abdelghani 2. B, Pilon fracture radiograph. A posterior pilon fracture is a pilon variant that is a challenging injury to treat and can result in poor functional outcomes for patients. Methods Sixty-nine patients were categorized into groups based on ankle position at the time of the injury: Group I (varus), Group II (valgus), Group III (dorsiflexion), Group IV (plantarflexion), and Group V (neutral). A, Anteromedial. C, Posterolateral (fibula). Pilon Fractures Philip Wolinsky University of California at Davis Medical Center Background Distal tibia fracture with intra-articular extension 1-10% of LE fx’s 20-25% are open 1/3 of patients have associated injuries Spectrum of Approaches to Treating Pilon Fractures Feat. Surgical Approaches (Fig. 5 A, B) (12), with soft tissuelesions type IIIA (Fig. Foot Ankle Spec . Internal fixation of the fracture and arthrodesis was performed using The aim of this study was to evaluate the pitfalls and strategies of posterior column reduction in the treatment of complex tibial pilon fractures (AO/OTA 43-C3). This video is a cadaveric dissection of the ankle showing first an anteromedial approach and then a posteromedial approach best used for pilon fractures. A Systematic Review of the Role of Surgical Approaches on the Outcomes of the Tibia Pilon Fracture. 2016 Apr;9(2):163-8. doi: 10.1177/1938640015620637. Background/aim:Pilon fracture is difficult to treat fractures due to many complications that can develop after surgery. An anterolateral approach is used to obtain plate fixation as shown in Figure A. 39. tibial plafond (pilon) fractures 1. Keywords: pilon fracture, plafond fracture, intra-articular ankle fractures, distal tibia fracture, AO/OTA 43A-C Introduction First described by French radiologist Destot in 1911, pilon fractures are defined as injuries that involve the articular weight-bearing surface of the distal tibia. Despite the … Among all Pilon … Cross-sectional schematic showing the intervals for common approaches to pilon fractures. Both the pilon fracture and the lateral talar dome fracture were addressed simultaneously through a combination of the small anterolateral and anteromedial approaches. He compared the talus to a pestle. 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