A comprehensive review of the existing literature, related to treatment options and management principles of pilon fractures was performed, and its results are presented. The identified series advocate in favour of a number of different treatment strategies and fixation methods. Decision making was mostly dependent on the severity of the local injury, the fracture pattern, the condition of the soft tissues, patient’s profile and surgical expertise. External fixation and conservative treatment did not provide sufficient articular congruence in many cases. Internal fixation allowed excellent restoration of joint congruity in Ru¨ edi type I and II fractures. A staged approach, consisting of fibular plating and temporary bridging external fixation, later substituted by an internal minimal invasive osteosynthesis or by a definitive external fixation, was favourable for Ru¨ edi type III fractures. Closed pilon fractures with bad soft tissue conditions (Tscherne 3) or open pilon fractures are regarded as contraindication of open reduction plate fixation. Anatomic reduction of the fracture, restoration of joint’s congruence, reconstruction of the posterior column, with minimal soft tissue insult, were all highlighted as of paramount importance.

Tibial pilon fractures : Which method of treatment? / G.M. Calori, L. Tagliabue, E. Mazza, U. de Bellis, L. Pierannunzii, B.M. Marelli, M. Colombo, W. Albisetti. - In: INJURY. - ISSN 0020-1383. - 41:11(2010 Nov), pp. 1183-1190.

Tibial pilon fractures : Which method of treatment?

M. Colombo
Penultimo
;
W. Albisetti
Ultimo
2010

Abstract

A comprehensive review of the existing literature, related to treatment options and management principles of pilon fractures was performed, and its results are presented. The identified series advocate in favour of a number of different treatment strategies and fixation methods. Decision making was mostly dependent on the severity of the local injury, the fracture pattern, the condition of the soft tissues, patient’s profile and surgical expertise. External fixation and conservative treatment did not provide sufficient articular congruence in many cases. Internal fixation allowed excellent restoration of joint congruity in Ru¨ edi type I and II fractures. A staged approach, consisting of fibular plating and temporary bridging external fixation, later substituted by an internal minimal invasive osteosynthesis or by a definitive external fixation, was favourable for Ru¨ edi type III fractures. Closed pilon fractures with bad soft tissue conditions (Tscherne 3) or open pilon fractures are regarded as contraindication of open reduction plate fixation. Anatomic reduction of the fracture, restoration of joint’s congruence, reconstruction of the posterior column, with minimal soft tissue insult, were all highlighted as of paramount importance.
Distal tibial; External fixation; MIPO; MIPPO; ORIF; Pilon fractures; Plafond fractures
Settore MED/33 - Malattie Apparato Locomotore
Settore MED/34 - Medicina Fisica e Riabilitativa
nov-2010
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/209307
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