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With the growing number of road traffic accidents and high-energy trauma events over recent years, traumatology departments have seen an increasing incidence of complex bone injuries with comminuted fractures and extensive soft tissue damage; these include fractures of the distal tibial metaphysis, more commonly known as “tibial pilon” fractures.
Since the first description of tibial pilon fractures by Destot in 1911 [1] many Authors have attempted to describe the mechanism of this injury. The goal was to establish a classification system to help determine the prognosis and evaluate the clinical outcomes of these debilitating ankle fractures [2–10]. Pilon fractures account for 1 to 7% of all tibial fractures [11–14], and are accompanied by...
The imaging of tibio-tarsal joint injuries varies according to the position and type of injury, which in turn usually depend on the type of accident. Injuries can be divided into either direct or indirect trauma. They both involve, mainly or exclusively, the skeletal apparatus and therefore the most common injuries are fractures. The ligament-capsule structures are frequently also involved particularly...
Injury to the tibio-tarsal region in childhood presents particular features which form the basis of this chapter on traumatology in the young. The ligamento-capsular complex is relatively robust in children, and therefore acute ligament injuries causing instability do not occur frequently, whereas minor distortions of the distal tibia are more commonplace, do not present any particular difficulty...
The term tibial pilon was first used by the French radiologist Destot in 1911 to identify the anatomical region corresponding to the distal third of the tibia, extending proximally approximately 5 cm from the joint line. The term tibial pilon fracture (7-10% of tibial fractures) is used to define a group of injuries that always involves the distal tibial articular surface with, in 85% of cases, fractures...
The standard term tibial pilon fracture is used for a group of injuries of the most distal part of the tibia, either intra or extra-capsular. There is almost always involvement of the articular surface which represents the dome of the tibio-fibulo-talar joint complex. Tibial pilon fractures comprise approximately 7% of tibial fractures and 1% of lower limb fractures but have always been a major problem...
External fixation was initially used as a first aid treatment, often temporary, for fractures which were severely open or associated with polytrauma [1], More recently it has been used by some authors as the method of choice in complex fractures of the tibial pilon, and the technique has been steadily gaining in popularity [2–5].
The incidence of severe lower leg trauma seems to be increasing in high-level trauma centres. This is probably due to the widespread use of automobile crash protection systems that mainly protect the upper body and head, but leave the lower part of the legs unprotected.
Because of the complex nature of tibial pilon fractures, and the difficulties that are presented during reconstruction, a wide variety of treatment methods has been proposed by different authors [1–8].
The long term prognosis of tibial pilon fractures depends on the type of fracture and is directly correlated to the fracture classification, as suggested by several authors [1–5].
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