A tibial plateau fracture is a common knee fracture. Note the abnormal tibiofemoral alignment (> 5 mm). Reliability of Radiologic Assessment of the Fracture Anatomy at the Posterior Tibial Plafond in Malleolar Fractures April 2009 Journal of orthopaedic trauma 23(3):208-12 Plafond fractures are also known as pilon fracture or explosion fracture anatomy. A pilon fracture, is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint.Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents. Fractures of the tibial plafond, or distal tibial articular surface, are usually associated with a high-force mechanism, which frequently can involve associated injuries and prolonged disability. Let Us Learn Orthopaedics- Tibial Plafond Fractures Pilon Fractures A Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. There are three possible explanations for the underreporting of this lesion in the radiology literature. There may be slight spreading of either half of the epiphysis away from the cleft. It involves the articular surface of the ankle joint. (A) Preoperative X-ray. Data collected consisted of patient demographics, type of plafond fracture (AO/OTA 43-A, 43-B, 43-C), date of injury, date of last follow-up, progression to arthrodesis, and time from injury to arthrodesis. 2.1 Intervention and outcome measurements. This article addresses pilon fractures—a specific type of fracture that occurs in the lower leg near the ankle. Type I: Intra-articular fracture of the distal tibia without significant displacement Type II: Intra-articular fracture of the distal tibia with significant displacement but minimal comminution Type III: Fracture of distal tibia with severe comminution and significant intra-articular displacement. I. Overview. Classifications in Brief: Schatzker classification of tibial plateau fractures. Classification. Female, 38 years old, with collapse fractures of the right tibial platform. Schatzker J et al. In distal tibia the cleft tends to prefer the medial plafond at its connection with the medial malleolus. This patient had marked comminution as well as articular impaction of the distal tibial plafond. 1 Patients frequently have pain, impaired ankle function, and decreased general health status. These fractures account for approximately 1% to 10% of the lower leg or tibial fractures and are often associated with severe bone comminution and soft tissue compromise. Figure 1. The injuries were graded according to AO Classification and the Gustillo-Anderson system. It involves the articular surface of the ankle joint. (C) Preoperative magnetic resonance imaging (MRI) scan showing the lateral tibial plateau fracture and the complete disruption of the medial collateral ligment. This is directly related to the special geometry of these fractures that have important transverse components. It is also known as Pilon fracture and explosion fracture. New York: McGraw-Hill, 2008: 307-316. Subtle fractures may be missed in a knee X-ray. Lateral knee X-ray with horizontal beam & AP image of the left knee. PMID: 445923. J Trauma 26(12): … Thirty-six tibial plafond fractures were followed over two years, with thirty-one MDCTs being obtained four months after injury, and twenty-two MDCTs after two years. Tibial Plafond Fractures - Trauma - Orthobullets Most articular fractures of the distal tibial weight-bearing surface are the result of motor vehicle accidents, motorcycle accidents, falls from heights, and industrial injuries. Paris, France: Masson & Cie, 1949. ♦ Tibial plafond fractures demand respect, largely due to the fragile soft tissue envelope that surrounds the distal tibia♦ Careful preoperative planning followed by meticulous operative handling of the soft tissues is required to avoid devastating complications. The prevalence of osteochondritis dissecans in the tibial plafond detected on radiography is unknown. Because of distracting injury and variations in clinical findings, tibial plafond fractures may be … In the most severe plafond fracture patterns, the articular segment is fractured into numerous pieces with certain segments driven proximally into the metaphysis, creating marked joint incongruity and associated metaphyseal defects. The pain had started gradually during a 10 mile running competition. Distal tibial triplane features, which constitute 6%-10% of epiphyseal injuries, are most accurately delineated and analyzed with computed tomography (CT). Schwartz DT. Tibial Fractures (Radiology (Mortise view: part of the 3 view series of…: Tibial Fractures (Radiology, Clinical presentation, Tibial Plateau fractures, Tibial shaft fractures, Tibial plafond fractures) Tibial pilon fractures: a comparative clinical study of management techniques and results. An insufficiency fracture of the tibial plateau may be the cause of knee pain in patients with osteoporosis. (B) Preoperative computed tomography (CT) scan showing the lateral central collapse of the right tibial platform of ~2 cm. Unilateral external fixation for severe pilon fractures. Pilon fractures are fractures of the distal tibial plafond. The lateral image shows lipohemarthrosis and a lateral tibial plateau fracture. To find in-depth information on ankle fractures, please read Ankle Fractures (Broken Ankle).. A pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint. According to the Ruedi and Allgower classification, this is a type III Pilon fracture. It is also known as Pilon fracture and explosion fracture. Zeltzer DW, Leopold SS. Let Us Learn Orthopaedics- Tibial Plafond Fractures Pilon Fractures A Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. Tibial Plafond Fractures is a topic covered in the 5-Minute Clinical Consult.. To view the entire topic, please sign in or purchase a subscription.. 5-Minute Clinical Consult (5MCC) app and website powered by Unbound Medicine helps you diagnose and manage 900+ medical conditions. The cause of tibial plafond fracture is axial or rotational forces occurring from motor vehicle accidents or falling from a height. Evolving treatment concepts for the pilon fracture. 1-5 Most studies that report outcomes after these fractures have assessed patients at a single point in time and report an average length of follow up. Clin Orthop Relat Res 1979; 138:94-104. The cause of Tibial Plafond Fracture is axial or rotational forces occurring from motor vehicle accidents or falling from a height. It is also known as Pilon fracture and explosion fracture. Salvage technique for treatment of periplafond tibial fractures: the modified fibula-pro-tibia procedure. Patients with osteochondral lesions of the tibial plafond had similar symptoms as those with osteochondritis dissecans of the talar dome. Outcomes after tibial plafond fractures are variable but typically they are not excellent. Cleft of distal tibial epiphyses most closely resemble Salter-Harris III or IV fractures. Unfortunately, clinical results with this technique were unreliable due to pathology (presumed arthrofibrosis) and technical problems (pooling of … Anterior tibial plafond fracture radiology. The Toronto experience 1968–1975. Emergency Radiology: Case Studies. Fractures of the tibial plafond. Tibial Plateau Fracture. A. Definition—Intraarticular fracture of the distal end of the tibia, also known as a tibial pilon fracture, involves disruption of the distal tibial weightbearing articular surface. Cleft tends to remain till the growth plate fuses. Explanation. Theorie et pratique de l’ osteosynthese. Aim: To report clinical and radiographic results of treatment of patients with complex open tibial pilon fractures. High-energy fractures are generally due to axial force that drives the talus into the tibial plafond, causing an “implosion” of the articular surface. It represents a wide spectrum of injury severity and accounts for approximately 5% to 7% of all tibia fractures and less than 1% of all lower-extremity fractures. A pilon fracture (also called a tibial plafond fracture) is a comminuted fracture of the distal tibia involving the ankle joint. Pilon Fractures or Tibial plafond fractures in their theory paper during university exams. Tibial Plafond Fracture is an uncommon fracture occurring in the distal region of the tibia. The tibial plateau fracture. One hundred sixty-eight tibial plafond fractures were identified and included in the study . References: Danis R, ed. Tibial Plafond Fracture - TeachMe Orthopedics Tibial Plafond Fracture - TeachMe Orthopedics Methods: A retrospective analysis in 14 patients with complex open pilon fractures treated between 2010 and 2015 was conducted. Fractures of the distal tibial plafond are also termed pilon fractures to describe the high energy axial compression force of the tibia as it acts as a pestle, driving vertically into the talus. Dillin L, Slabaugh P (1986) Delayed wound healing, infection, and nonunion following open reduction and internal fixation of tibial plafond fractures. Figure 20. 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