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It is also known as Pilon fracture and explosion fracture. New York: McGraw-Hill, 2008: 307-316. It represents a wide spectrum of injury severity and accounts for approximately 5% to 7% of all tibia fractures and less than 1% of all lower-extremity fractures. Let Us Learn Orthopaedics- Tibial Plafond Fractures Pilon Fractures A Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. It involves the articular surface of the ankle joint. This patient had marked comminution as well as articular impaction of the distal tibial plafond. In the most severe plafond fracture patterns, the articular segment is fractured into numerous pieces with certain segments driven proximally into the metaphysis, creating marked joint incongruity and associated metaphyseal defects. It is also known as Pilon fracture and explosion fracture. (B) Preoperative computed tomography (CT) scan showing the lateral central collapse of the right tibial platform of ~2 cm. Fractures of the tibial plafond, or distal tibial articular surface, are usually associated with a high-force mechanism, which frequently can involve associated injuries and prolonged disability. According to the Ruedi and Allgower classification, this is a type III Pilon fracture. Thirty-six tibial plafond fractures were followed over two years, with thirty-one MDCTs being obtained four months after injury, and twenty-two MDCTs after two years. A pilon fracture (also called a tibial plafond fracture) is a comminuted fracture of the distal tibia involving the ankle joint. Evolving treatment concepts for the pilon fracture. Type I: Intra-articular fracture of the distal tibia without significant displacement Type II: Intra-articular fracture of the distal tibia with significant displacement but minimal comminution Type III: Fracture of distal tibia with severe comminution and significant intra-articular displacement. An insufficiency fracture of the tibial plateau may be the cause of knee pain in patients with osteoporosis. To find in-depth information on ankle fractures, please read Ankle Fractures (Broken Ankle).. A pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint. Figure 1. Tibial pilon fractures: a comparative clinical study of management techniques and results. Schatzker J et al. (C) Preoperative magnetic resonance imaging (MRI) scan showing the lateral tibial plateau fracture and the complete disruption of the medial collateral ligment. Theorie et pratique de l’ osteosynthese. The tibial plateau fracture. Because of distracting injury and variations in clinical findings, tibial plafond fractures may be … Emergency Radiology: Case Studies. High-energy fractures are generally due to axial force that drives the talus into the tibial plafond, causing an “implosion” of the articular surface. 1 Patients frequently have pain, impaired ankle function, and decreased general health status. Tibial Plafond Fracture - TeachMe Orthopedics Tibial Plafond Fracture - TeachMe Orthopedics Tibial Fractures (Radiology (Mortise view: part of the 3 view series of…: Tibial Fractures (Radiology, Clinical presentation, Tibial Plateau fractures, Tibial shaft fractures, Tibial plafond fractures) Salvage technique for treatment of periplafond tibial fractures: the modified fibula-pro-tibia procedure. References: Danis R, ed. J Trauma 26(12): … 1-5 Most studies that report outcomes after these fractures have assessed patients at a single point in time and report an average length of follow up. I. Overview. Tibial Plateau Fracture. Classifications in Brief: Schatzker classification of tibial plateau fractures. Classification. Aim: To report clinical and radiographic results of treatment of patients with complex open tibial pilon fractures. These fractures account for approximately 1% to 10% of the lower leg or tibial fractures and are often associated with severe bone comminution and soft tissue compromise. ♦ Tibial plafond fractures demand respect, largely due to the fragile soft tissue envelope that surrounds the distal tibia♦ Careful preoperative planning followed by meticulous operative handling of the soft tissues is required to avoid devastating complications. Trimalleolar fractures usually include a lateral malleolar fracture, a triangular fracture of the posterolateral corner of the tibial plafond, and a horizontal or oblique fracture of the medial malleolus. Figure 20. Lateral knee X-ray with horizontal beam & AP image of the left knee. It is also known as Pilon fracture and explosion fracture. Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. Methods: A retrospective analysis in 14 patients with complex open pilon fractures treated between 2010 and 2015 was conducted. (A) Preoperative X-ray. Schwartz DT. Note the abnormal tibiofemoral alignment (> 5 mm). Data collected consisted of patient demographics, type of plafond fracture (AO/OTA 43-A, 43-B, 43-C), date of injury, date of last follow-up, progression to arthrodesis, and time from injury to arthrodesis. There may be slight spreading of either half of the epiphysis away from the cleft. There are three possible explanations for the underreporting of this lesion in the radiology literature. It involves the articular surface of the ankle joint. Let Us Learn Orthopaedics- Tibial Plafond Fractures Pilon Fractures A Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. Tibial Plafond Fractures - Trauma - Orthobullets Most articular fractures of the distal tibial weight-bearing surface are the result of motor vehicle accidents, motorcycle accidents, falls from heights, and industrial injuries. Fractures of the distal tibial plafond are also termed pilon fractures to describe the high energy axial compression force of the tibia as it acts as a pestle, driving vertically into the talus. This article addresses pilon fractures—a specific type of fracture that occurs in the lower leg near the ankle. The prevalence of osteochondritis dissecans in the tibial plafond detected on radiography is unknown. Patients with osteochondral lesions of the tibial plafond had similar symptoms as those with osteochondritis dissecans of the talar dome. Anterior tibial plafond fracture radiology. Tibial Plafond Fractures is a topic covered in the 5-Minute Clinical Consult.. To view the entire topic, please sign in or purchase a subscription.. 5-Minute Clinical Consult (5MCC) app and website powered by Unbound Medicine helps you diagnose and manage 900+ medical conditions. This is directly related to the special geometry of these fractures that have important transverse components. One hundred sixty-eight tibial plafond fractures were identified and included in the study . A tibial plateau fracture is a common knee fracture. Reliability of Radiologic Assessment of the Fracture Anatomy at the Posterior Tibial Plafond in Malleolar Fractures April 2009 Journal of orthopaedic trauma 23(3):208-12 The cause of tibial plafond fracture is axial or rotational forces occurring from motor vehicle accidents or falling from a height. A pilon fracture, is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint.Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents. Fractures of the tibial plafond. Pilon fractures are fractures of the distal tibial plafond. Cleft tends to remain till the growth plate fuses. Distal tibial triplane features, which constitute 6%-10% of epiphyseal injuries, are most accurately delineated and analyzed with computed tomography (CT). Zeltzer DW, Leopold SS. Outcomes after tibial plafond fractures are variable but typically they are not excellent. Plafond fractures are also known as pilon fracture or explosion fracture anatomy. The pain had started gradually during a 10 mile running competition. Unilateral external fixation for severe pilon fractures. In distal tibia the cleft tends to prefer the medial plafond at its connection with the medial malleolus. The cause of Tibial Plafond Fracture is axial or rotational forces occurring from motor vehicle accidents or falling from a height. Dillin L, Slabaugh P (1986) Delayed wound healing, infection, and nonunion following open reduction and internal fixation of tibial plafond fractures. The lateral image shows lipohemarthrosis and a lateral tibial plateau fracture. A. Definition—Intraarticular fracture of the distal end of the tibia, also known as a tibial pilon fracture, involves disruption of the distal tibial weightbearing articular surface. Clin Orthop Relat Res 1979; 138:94-104. PMID: 445923. Explanation. Cleft of distal tibial epiphyses most closely resemble Salter-Harris III or IV fractures. Subtle fractures may be missed in a knee X-ray. 2.1 Intervention and outcome measurements. Pilon Fractures or Tibial plafond fractures in their theory paper during university exams. Paris, France: Masson & Cie, 1949. Female, 38 years old, with collapse fractures of the right tibial platform. 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