Beruflich Dokumente
Kultur Dokumente
- EVALUATION
( Clinical, physical and imaging )
- CLASSIFICATIONS
- ASSOCIATED INJURIES
- TREATMENT
- COMPLICATIONS
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A
N
A
T
O
Talus
M
Y
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A
N
A
T
O
M
Y
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What is Pilon Fracture?
Pilon is a French word for pestle ( also known as
Plafond Fracture ) .
It is intraarticular
fracture of the distal
end of the tibia ,
involving the disruption
of the distal tibial
weight-bearing
articular surface .
It is different from ankle fractures .
In most cases, both bones are broken .
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EPIDEMIOLOGY
Account for approximately 5-7% of all tibia fractures.
But less than 1% of all lower-extremity fractures .
More commonly at average age of 35 to 40 years old.
rare in children and elderly.
Commonly in men than women (3:1)
Because of the energy required to cause this type of
fracture, 25% to 50% of patients have additional
injuries that require treatment.
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Mechanism
Pilon fractures are most often caused by axial loading (high-
energy impacts or combination),
such as : Fall from height , Motor-vehicle accident .
- Leads to ( high degree of disruption of articular surface and soft tissue affection )
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EVALUATION
Clinical presentation
Physical examination
Imaging
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E
V Clinical presentation
A
L
Signs and symptoms
U include an inability to bear weight , marked pain , marked
swelling , and evidence of soft tissue injury and deformity ( out
A of place ) .
T
I
O
N Powerpoint Templates
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E
V Physical examination
A Neurovascular examination
include distal pulses , capillary refill , motor and sensory examination .
L Soft tissue
- Closed fractures : classified using the method of Tscherne
A
T
I
O
N Powerpoint Templates
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E
V Imaging
A
L
U
A
T
I
O
N Powerpoint Templates
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E
V Imaging
A
L
U
A
T
I
O
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CLASSIFICATIONS
Association for Osteosynthesis/Orthopedic
trauma association (AO/OTA) Classification
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T TREATMENT and RATIONAl
R
E Treatment goals
A Treatment options
T Bony considerations
M soft tissue considerations
E Timing of surgery
N
T
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T Treatment goals
R - Anatomical restoration of distal tibial articular surface .
- Early ankle range of motion.
E
A Treatment options
T Non-surgical Surgical
( to manage ( To manage displaced
M non-displaced fractures) fractures )
E Cast and Splints Modern methods :
N (ORIF) and external
fixation with or without
T limited internal fixation
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T Bony considerations
R Tibia Fibula
- Comminution
E - Lower energy : (ORIF) ORIF with plate and
A - High energy + large scrow
number of small
T articulations :
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ANATOMICAL
CONSEDARATIONS AND
SURGICAL TECHNIQUES
ORIF
External fixation
- Unilateral
- ilizarvo ( consists of fine wire 1.8mm for interfragmentary fixation ) .
- hybird ( ring with wire distally )
Soft tissue
Ligamentotaxis
When traction is applied across the ankle joint , the intraarticular fragments
may be reduced by pull of the capsule and ligamentous structures .
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COMPLICATIONS
Sever complications following ORIF of tibial fractures
range from 10-55% and some can lead to amputation
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Thank you
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