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Pilon Fractures of the Distal Tibia: A Test of Surgical Judgment

Conference paper

Abstract

Intra-articular fractures of the distal tibia are difficult fractures to manage [1, 6–11, 13, 31, 40]. In the 1960s, in the hands of certain members of the AO group, successful surgical treatment of this group of fractures was carried out. By the 1970s, papers on operative management based on the AO principles began to appear in the British orthopedic literature [14, 15, 34–37]. These clinical studies were optimistic about what might be expected to be achieved by the application of the AO group’s methods. Until these references appeared British literature on the pilon fracture was, at best, cautionary to pessimistic. Jergesen, of California, typified this thinking when in his article “Fractures of the Ankle”, written in 1959 [19], he stated that “explosion fractures of the distal end of the tibia were not amenable to open reduction and internal fixation”. Later papers by Leach [23], Sheck [39] and Rouff and Shnider [4] tried to illustrate through limited clinical studies, techniques that had been helpful to the authors in their attempts to salvage ankles in patients with these fractures. These techniques were directed toward internal fixation of the fibula as an isolated event, and preoperative planning with isolated percutaneous fixation of the major articular fragments.

Keywords

Internal Fixation Distal Tibia Ankle Fracture Posterior Tibial Tendon Cancellous Bone Graft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • J. Mast

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