Journal List > J Korean Orthop Assoc > v.26(3) > 1115077

Kim, Yoon, Rhee, Oh, and Cheong: A Clinical Study of The Tibial Pilon Fractures

Abstract

The intra-articular fractures of the lower end of the tibia, the so called pilon tibial fractures, are the severe injuries to the ankle joint and it offers difficult challenges it managing in because of their severity. The mechanism of their injuries is the vertical compression forces, shear and/or rotational forces, but vertical compression forces are the common denominator of these fractures. The recommanded treatments have included manipulation & cast application, calcaneal traction using pins in plaster, external fixators, vertical transarticular pin fixation, percutaneous pinning of large fragments and immobilization in a plaster cast, fibular stabilization, limited open reduction & internal fixation. The results of treatment of 25 cases were analyzed & evaluated at the Department of Orthopaedic Surgery, Joong Ang Gil Hospital from Mar. 1985 to Feb. 1989. The results were as follows. 1. The associated injuries were spinal compressive fractures (5 cases) and akull fractures (4 cases). 2. The combined injuries in ipsilateral lower extremity were fibular fractures (22 cases; 88%) and distal tibiofibular diastasis (3 cases; 12%). 3. The most frequent type of fractures was type II (15 cases; 60%) according to Ruedi & Allgower classification. 4. Open reduction & internal fixation in cases of type II & III has showed better results than those treated conservatively. 5. The most often complication was the ankle joint pain.

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