Abstract
Traditionally, fractures of the tibial plafond have been treated by open reduction and internal fixation, with the goals of exact restoration of the articular surface and sufficient stability to allow early motion. Unfortunately, this method of treatment often leads to an unacceptable incidence of complications, many of which are severe. Satisfactory results and a substantial decrease in complications have recently been reported when the metaphyseal portion of the fracture is treated by external fixation. For this reason, the accepted techniques used to treat tibial plafond fractures have changed. The goal is now to preserve the soft tissue envelope by reducing the fracture percutaneously or through limited approaches using stabilization remote from the fracture site by external fixation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bonar SB, and Marsh JL: ‘Unilateral external fixation for severe pilon fractures’. Foot Ankle 1993; 14: 57–64.
Bonar SB, and Marsh JL: ‘Tibial Plafond Fractures: Changing Principles of Treatment’. Am Academy Orthopaedic Surgeons: A Comprehensive Review 1994; 2: 297–305.
Bone L, Stegemann P, McNamara K, Seibel R: ‘External fixation of severely comminuted and open tibial pilon fractures’. Clin Orthop 1993; 292: 101–7.
DeCoster T.: Personal Communication, 1994.
Destot E: Traumatismes du pied et ryon malleoles, astralage, calcaneus, avant-pied. Masson: Paris, 1911.
Etter C, Ganz R: ‘Long-term results of tibial plafond fractures treated with open reduction and internal fixation’. Arch Orthop Trauma Surg 1991; 210: 277–83.
Fitzpatrick DC, Marsh JL, Brown T.D.: ‘Articulated external fixation of pilon fractures: the effects on ankle joint kinematics’. J Orthop Trauma 1995; 9: 76–82.
Friel JP. Dorland’s Illustrated Medical Dictionary, 25th ed. WB Saunders, 1974.
Gustilo RB, Anderson JT: ‘Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. Retrospective and prospective analysis’. J Bone Joint Surg [Am] 1976; 58A: 453–8.
Marsh JL, Bonar S, Nepola JV, Decoster TA, Hurwitz SR. ‘Use of an Articulated External Fixator for Fractures of the Tibial Plafond’. J Bone Joint Surg [Am] 1995; 77-A: 1498–509.
Marsh JL, Bonar S, Nepola, JV, DeCoster T, Hurwitz S, LeClare, W.: ‘Tibial plafond fractures - A prospective protocol utilizing articulated external fixation’. Orthopaedic Transactions, Vol. 17, No. 4, p. 1038,1993–1994.
McFerran MA, Smith SW, Boulas HJ, Schwartz HS: ‘Complications encountered in the treatment of pilon fractures’. J Orthop Trauma 1992; 6:195–200.
Müller ME, Nazarian S, Koch P, and Schatzker J: The Comprehensive Classification of Fractures of Long Bones. Springer-Verlag: Berlin Heidelberg, 1990, pp 170–9.
Rüedi TP, Allgöwer M.: ‘The operative treatment of intraarticular fractures of the lower end of the tibia’. Clin Orthop 1979; 138: 105–10.
Saleh M., Shanahan MDG, Fern ED: ‘Intra-articular fractures of the distal tibia: surgical management by limited internal fixation and articulated distraction’. Injury 1993; 24: 37–40.
Teeny SM, Wiss DA: ‘Open reduction and internal fixation of tibial plafond fractures: variables contributing to poor results and complications’. Clin Orthop 1993; 292: 108–17.
Tornetta P, Weiner L, Bergman M, Watnik N, Steuer J, Kelley M, Yang E.: ‘Pilon fractures: treatment with combined internal and external fixation’. J Orthop Trauma 1993; 7: 489–96.
Tredwell JR, Fallat LM: ‘Dynamic unilateral distraction fixation: surgical management of tibial pilon fractures’. J Foot Ankle Surg 1994; 33: 438–42.
Tscherne H, Goetzen L, ed. Fractures with Soft Tissue Injuries. Springer-Verlag: Berlin, 1984.
Varela CD, Vaughan TK, Carr JB, Slemmons BK: ‘Fracture blisters: clinical and pathological aspects’. J Orthop Trauma 1993; 7: 417–27.
Webster’s Ninth New Collegiate Dictionary, G and C Merrian Co., 1980.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer-Verlag London Limited
About this chapter
Cite this chapter
Marsh, J.L. (2000). Distal Tibial and Plafond Fractures. In: De Bastiani, G., Apley, A.G., Goldberg, A. (eds) Orthofix External Fixation in Trauma and Orthopaedics. Springer, London. https://doi.org/10.1007/978-1-4471-0691-3_27
Download citation
DOI: https://doi.org/10.1007/978-1-4471-0691-3_27
Publisher Name: Springer, London
Print ISBN: 978-1-4471-1178-8
Online ISBN: 978-1-4471-0691-3
eBook Packages: Springer Book Archive