Tibial pylon fracture

INTRODUCTION: Tibial pylon fractures are difficult to manage injuries due to their anatomical situation, mechanism of production, and damage to the surrounding soft tissue. Surgical treatment is the most widely used, including external fixation that can be used temporarily or permanently. OBJECTIVE: To evaluate the use of external fixation in patients with tibial pylon fractures. MATERIAL AND METHODS: A pre-experimental study with a level of evidence II, recommendation grade B, was carried out in 34 patients with tibial pylon fracture, treated from January 2014 to February 2020...

BACKGROUND: Several treatment are available for these injuries. In developed countries they are currently treated with minimally invasive plates. This paper describes the results obtained using external fixators in patients with tibial pylon fractures. METHODS: A retrospective, cross-sectional study was conducted from 1999 to 2009 at Querétaro General Hospital. A total of 39 patients were operated on; 18 met the inclusion criteria; follow-up ranged from 1 to 9 years...

High-energy tibial pylon fractures represent some of the most severe injuries of the ankle joint and currently represent a challenge for the orthopedic surgeon. These are usually polytraumatized patients and before admitting them into the traumatology unit, spinal cord, pelvic or thoracoabdominal injuries should be ruled out. Due to the special anatomy of the area, its thin skin cover and subcutaneous location, soft tissues are usually severely affected and this is key when choosing the time for a surgical intervention...

UNLABELLED: The study included 35 patients with fractures of distal tibia treated at the department of orthopedics HC K. Mitrovica and the Orthopedic clinic in CHC of Nis by a dynamic external fixator fixation of ancle. Ovadia-Beals score was used to assess the quality and repositioning and to assess the stability assessment made osteosynthesis. The final functional result of treatment the patient was determined based on the AOFAS score. Deviations for postoperative talocrural angle for extraarticular fractures was approximately 6 degrees (excellent result)...

INTRODUCTION: Intraarticular fractures of the distal tibia are traumas accounting for 1% of lower extremity fractures. The tibial pylon fracture is a metaphyseal lesion that spreads inside the ankle and is difficult to treat with any method. CASE REPORT: This is the clinical outcome at one year, of a 40-year-old male patient with a bilateral tibial pylon fracture, treated with the MIPO (minimally-invasive plate osteosynthesis) technique. RESULTS: It was possible to reduce complications such as bone and soft tissue infections, early arthrosis and pseudoarthrosis, and to achieve the patient's prompt return to activities of daily living, thus reducing the costs to the patient and the institution...

PURPOSE OF THE STUDY: To report on the surgical treatment of intra-articular calcaneal fractures by open reduction and internal fixation with a calcaneal locking compression plate (LCP) from an extended lateral approach, and to retrospectively analyze the mid-term results in a group of patients treated by this technique. MATERIAL: In the period from August 2005 till March 2007, a total of 49 patients with 61 calcaneal fractures were treated. Of these, 11 (18 %) were treated conservatively...

We have compared the outcomes of the use of external fixation devices for spanning or sparing the ankle joint in the treatment of fractures of the tibial plafond, focusing on the complications and the rates of healing. We have devised a scoring system for the quality of reporting of clinical outcomes, to determine the reliability of the results. We conducted a search of publications in English between 1990 and 2006 using the Pubmed search engine. The key words used were pilon, pylon, plafond fractures, external fixation...

PURPOSE OF THE STUDY: Fractures of a tibial pylon are serious problems in traumatology. The methods of their therapy have not been unified yet and treatment outcomes are not satisfactory. This is often due to extensive comminution of the distal tibia, bone defects or a thin coverage of soft tissue. The objective of this study is to compare the literature data and, on the basis of this and our own experience, to present guidelines for the treatment of fractures of tibial pylons. MATERIAL: In the period from 1998 to June 2002, 60 patients (average age, 42 years) underwent surgery for a fracture of the tibial pylon in the Department of Orthopedics, IPVZ, and in the hospital Na Bulovce, First Faculty of Medicine, Charles University in Prague...

The results of the treatment of 18 cases of nonunion of the tibial pylon using the Ilizarov method are presented. The level of the nonunion was divided into A (epiphyseal, 2 cases), B (from 1 to 4 cm from the joint rima, 7 cases), and C (from 4 to 7 cm from the rima, 9 cases). Nonunion was atrophic in 12 cases, hypertrophic in 2, and infected in 4. Bone grafts were applied in 8 atrophic cases, while bone resection with transport or resection-shortening was performed in the 4 cases with infection, or resection-shortening and then lengthening in 2 cases...

Although most of the controversy surrounding the treatment of intra-articular, vertical impact fractures of the lower tibia is due to the difficult clinical problems they pose, there is a minor, ongoing dispute regarding nomenclature. In the last several decades, these fractures have been called either pilon or pylon fractures. This study traces the etymology of both terms and relates them to their usage in the orthopaedic literature. Based on the origins of each word, and how they were introduced into the orthopaedic literature, it is concluded that the correct term for an intra-articular, vertical impact fracture of the lower tibia is pilon fracture...

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We reviewed the clinical results of 332 fractures treated with the Ilizarov external fixator between 1984 and 1993. The locations of the involved bones were: tibia, 247 (including 28 with tibial pylons); femur, 47; humerus, 21; forearm, 12 and calcaneus, 5. The clinical outcomes of this series were retrospectively evaluated by radiological and clinical rating systems. In the tibial fractures, results in 71.1% were categorized as excellent or good, without deep infection; 63.3% of the tibial pylon fractures, mostly open, also showed excellent or good results...

Below the knee amputation after trauma is an appropriate option for many patients with recalcitrant infection and nonunion of the tibia. Patients who have had transtibial amputations have lower energy expenditure, heart rate, and oxygen cost when ambulating with their prostheses than when using a three-point gait with crutches without their artificial limb. Innovative prosthetists have improved each of the five essential components of the limb amputated below the knee: socket, insert, shaft and pylon, foot and ankle assembly, and suspension system...

Twenty cases of pylon fractures were treated with IIizarov circular external fixators using the technique of ligamentotaxis. Fourteen men and six women, ranging in age from 20 to 59 years, with open or closed distal tibial fractures were included in this study. The fractures were classified according to the AO system and distributed as seven C1, eight C2, and five C3 fractures. Independent from the type of fracture, six were grade II open according to the Gustilo-Anderson classification. For all fractures, an external fixator was constructed, after reduction by traction and olive wires...

The necessity for a short operative procedure that does not cause additional stress to the soft tissue overlying pylon fractures and at the same time enables the surgeon to reconstruct the distal articular surface of tibia and fibula, which includes achieving the correct length, led us to develop a new procedure in the acute treatment of such fractures. Therefore our operative procedure starts with indirect reduction and stabilization of the fibula by means of intramedullary Kirschner wires. For a precise analysis of the main fracture fragments of the distal tibia, we continue with reduction of the articular surface by means of ligamentotaxis and stabilization with angular external fixator without bridging the ankle joint...

Between 1982 and 1992, 79 pylon fractures were treated with internal fixation as the primary treatment at the trauma department of the Hannover Medical School. In a retrospective study 71 patients were evaluated, and 51 of them were re-examined clinically and radiographically an average of 68 months after injury. The purpose of this study was to compare these different forms of surgical management concerning their long-term results: 1. Minimal invasive internal fixation for reconstruction of the joint with external transfixation of the ankle joint and/or plaster cast until bony healing occurred...

Ninety-five open fractures of the joint at the distal end of the lower leg (73 ankle fractures, 22 fractures of the pylon tibia) were treated between 1970 and 1987. For different reasons (death, amputation, etc.) only 63 could be followed up. The clinical and radiological assessments of 60 patients are presented in this paper. The Weber evaluation (only 18% good-to-excellent results) seemed to be inadequate for grading these cases. Fifty-six percent of the patients rated the results as very good, 37% as good...

When stabilizing fractures with large soft tissue and bone defects, the primary concern is to avoid additional vascularization damage. Therefore, external fixation is still the standard method. In metaphysical fractures, joint transfixation should be avoided if possible. Concerning closed comminuted fractures of femoral and tibial shaft fractures, interlocking nailing shows the lowest complication rate. The introduction of unreamed nailing of open fractures shows the same low infection rate as external fixation, so it can be considered an alternative method...

No abstract text is available yet for this article.

No abstract text is available yet for this article.