Intraarticular "pilon" fracture of the tibia.
Classification and treatment options for the management of tibial pilon fractures are reviewed. For comminuted and/or displaced fractures that require open reduction and internal fixation, a detailed description of the surgical technique, including indirect reduction techniques, is provided. Thirty-four pilon fractures (32 patients) treated during a period of five years (1984-1989) were reviewed. All were high-energy injuries (15 patients with multiple trauma) with Rüedi-Allgöwer Type II in 26 and Type III in eight. Eighteen (56%) were open fractures. Six fractures were treated with external fixation and the remaining 28 with open reduction and internal fixation. The patient follow-up examination period averaged 16.2 months (range, six to 38 months). Thirty (88%) fractures had united by 16 weeks (two delayed unions, one below knee amputation, and one plate breakage). In the 26 Type II fractures, functional grading found 17 excellent (65%) and six (23%) poor results. In the eight Type III fractures, there were four (50%) excellent and three (37%) poor results. Complications included one superficial pin-tract infection and two deep wound infections, both in Grade II open fractures.
Helfet
D L
DL
Orthopaedic Trauma Service, Tampa General Hospital, Florida.
Koval
K
K
Pappas
J
J
Sanders
R W
RW
DiPasquale
T
T
D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*