Open reduction and internal fixation of tibial pilon fractures. KEY FACTS • The tibial pilon fracture is a rare, yet devastating injury. Posttraumatic arthrosis affecting the ankle after a severe pilon fracture (Ruedi type II or III) was a progressive disease, and required long-term follow-up. Many pilon fractures occur due to high energy injuries such as motor vehicle accidents, falls from a height, or high-velocity sports injuries such as falling when skiing. Seventeen patients with Pilon fractures were enrolled in this retrospective … The average age of someone with a pilon fracture is 35 to 40 years old. Long-term results of pilon fractures. [Pilon fractures : Review of diagnostics and classification]. Operative concurrent fixation of the fractured fibula resulted in a better outcome than non-operative treatment (P < 0.05). NLM J Orthop Trauma 18(8 suppl):S32–S38, Teeny SM, Wiss DA (1993) Open reduction and internal fixation of tibial plafond fractures. J Trauma 19:593–601, PubMed  Article  The long-term outcome of pilon fractures was affected by fracture patterns, fibular length restoration, quality of reduction, and severity of soft tissue injury. Results: Open reduction with plating was a reasonably effective procedure for the treatment of Ruedi type I pilon fractures. Long-term retrospective study of 51 fractures treated with open reduction and osteosynthesis] Arlettaz Y, Blanc CH, Chevalley F. Rev Chir Orthop Reparatrice Appar Mot, 84(2):180-188, 01 Apr 1998 Cited by: 1 article | PMID: 9775062. Review Google Scholar, Leone VJ, Ruland RT, Meinhard BP (1993) The treatment of the soft tissue in pilon fractures. Improving the prognosis will inevitably involve a multidisciplinary approach, taking into consideration a number of variables. Isolated fractures of the bones that have minimal to no disruption of the joint surface have an excellent long-term prognosis provided that there is excellent anatomic position of the fractures. Open fractures had significantly lower satisfactory outcomes than closed fractures (60.5% versus 78.9%, P < 0.05). Clin Orthop 292:108–117, Topliss CJ, Jackson M, Atkins RM (2005) Anatomy of pilon fractures of the distal tibia. 1, 2 The mechanism of injury has two components: a vertical compressive component and a torsional component, both individually having the potential to displace a posterior malleolar fragment. Injury 24:37–40, Sirkin M, Sanders R, DiPasquale T et al (2004) A staged protocol for soft tissue management in the treatment of complex pilon fractures. The long-term results of pilon fractures are rarely documented. They often result in an obvious deformity of the ankle joint. Dr. Brown paraphrased 3/ fracture creation and cartilage culture Cartilage close to fracture line (<1 mm) Cartilage away from fracture line (>3mm) Decreased early viability close to fracture line (8% vs 1% dead chondrocytes) More rapid further decline in viability ( 26% vs 9% dead chondrocytes) Note: no statistical difference between t=0 and t=48h in Introduction: Articular fractures deliver blunt trauma to the cartilage and disrupt the articular surface and subchondral bone. Pilon fractures are usually related to significant surrounding soft tissue injury caused by high energy trauma, which may result in failure of untimely fixation and a series of complications such as skin flap necrosis or deep infection, so that appropriate soft tissue management contributes to success of Pilon fractures’ treatment. Archives of Orthopaedic and Trauma Surgery 1998 Apr;84(2):180-8. Epub 2020 Jun 9. Epub 2007 Mar 13. At the end of follow-up, the clinical results were evaluated using a rating scale. The long-term results of pilon fractures are rarely documented. CAS  2014; 472(12):3823–3834. Learn more about Institutional subscriptions, Ayeni JP (1988) Pilon fractures of the tibia: a study based on 19 cases. J Orthop Trauma 7:489–496, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan, Department of Orthopedic Surgery, Taipei City Hospital, Heping Branch, No. Freeman K, Michalson JL, Anderson DD, Brown TD, DeCoster TA, Dirschl DR, Karam MD, Marsh JL. Keywords Pilon fractures Management Strategy Algorithm Reconstruction Bone defects Introduction Pilon is the French word for a pestle. [2][3][4] 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. [Fractures of the tibial pilon. High-energy tibial ‘pilon’ fractures … Visit the post for more. Complications that may occur with pilon fractures include: Stiffness. Clipboard, Search History, and several other advanced features are temporarily unavailable. Pilon is the French word for "pestle"—an instrument used for crushing or pounding. The radiographs were reviewed for adequacy of fracture reduction and posttraumatic arthrosis. When it does enter the ankle joint, it normally does so posteriorly or medially. Patients: Subscription will auto renew annually. J Bone Joint Surg Am 77:1498–1509, Marsh JL, Weigel DP, Dirschl DR (2003) Tibial plafond fractures. © 2020 Springer Nature Switzerland AG. Owing to this, the implications on the long-term prognosis are significantly affected by the damage inflicted during the event. Clin Orthop 240:42–46, Conroy J, Agarwal M, Giannoudis PV et al (2003) Early internal fixation and soft tissue cover of severe open tibial pilon fractures. Scaglione M, Celli F, Casella F, Fabbri L. Musculoskelet Surg. Clin Orthop 138:105–110, Saleh M, Shanahan MD, Fern ED (1993) Intra-articular fractures of the distal tibia: surgical management by limited internal fixation and articulated distraction. 33, Section 2, Chung-Hwa Rd, Taipei, Taiwan, You can also search for this author in Improving the prognosis will inevitably involve a multidisciplinary approach, taking into …  |  One hundred and twenty-eight pilon fractures with a mean 10-year follow-up were divided into three groups, based on the Ruedi-Allgower classification. The purpose of this study was to present the treatment outcome for patients with posterior pilon fractures treated with buttress plate. Tibial pilon fractures treated with hybrid external fixator: analysis of 75 cases. Yih-Shiunn Lee. eCollection 2016 Oct. [Fractures of the tibial pilon. Commonly, the fibula bone in the ankle is broken as well. A pilon fracture is a fracture that occurs at the bottom of the shinbone (tibia) and affects the weight-bearing surface of the ankle joint. Groups B and C had progressively increased ankle arthrosis with time (P = 0.043, P = 0.049, respectively). Open fractures had significantly lower satisfactory outcomes than closed fractures (60.5% versus 78.9%, P < 0.05). J Bone Joint Surg Br 87:692–697, Tornetta P 3rd, Weiner L, Bergman M et al (1993) Pilon fractures: treatment with combined internal fixation and external fixation. Rotational pilon fractures present an entirely different fracture confi guration and long term prognosis. https://doi.org/10.1007/s00402-006-0225-3, DOI: https://doi.org/10.1007/s00402-006-0225-3, Over 10 million scientific documents at your fingertips, Not logged in Etienne Destot, a French Radiologist, is credited for using the term to describe the fracture in 1911. EFORT Open Rev. 2009 Jun;33(3):695-9. doi: 10.1007/s00264-008-0654-4. 2017 Mar 13;1(10):354-361. doi: 10.1302/2058-5241.1.000016. Poor prognosis was reported for complex Pilon fractures involving severe soft tissue damage. J Trauma 26:1116–1119, PubMed  Owing to this, the implications on the long-term prognosis are significantly affected by the damage inflicted during the event. This chapter focuses on the clinical presentation, diagnosis, treatment options, and long-term prognosis of pilon fractures utilizing both retrospective and prospective data ranging from 1975 to 2017. long-term prognosis and pertain a higher risk of degenerative changes [1]. Clin Orthop 292:101–107, PubMed  While fractures can safely be reduced using staged ORIF, reported functional recovery is poor. Bonin, 11 in 1950, described the same fracture as a “plafond” fracture because the fracture disrupted the roof of the ankle joint. Google Scholar, Marsh JL, Bonar S, Nepola JV et al (1995) Use of an articular external fixator for fractures of the tibial plafond. Men are three times more likely than women to have pilon fractures… 2017 Aug;120(8):632-639. doi: 10.1007/s00113-017-0363-9. https://doi.org/10.1007/s00402-006-0225-3. Arch Orthop Trauma Surg 127, 55–60 (2007). A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from a height. Article  PubMed Google Scholar. These can … NIH Article  2019 Apr;103(1):83-89. doi: 10.1007/s12306-018-0550-z. It is therefore useful to explore the evolution of different treatment strategies in an effort to reconstruct the axial alignment and articular surface, while minimizing additional damage to the surrounding soft tissues. Posttraumatic arthrosis affecting the ankle after a severe pilon fracture (Ruedi type II or III) was a progressive disease, and required long-term follow-up. 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