Authors :
Samir Ben Salah; Ayman Ben Abdallah; Adnane Lachkar; Hicham Yacoubi; Najib Abdeljaouad
Volume/Issue :
Volume 7 - 2022, Issue 6 - June
Google Scholar :
https://bit.ly/3IIfn9N
Scribd :
https://bit.ly/3PtxoME
DOI :
https://doi.org/10.5281/zenodo.6834454
Abstract :
Fractures of the tibial pilon remain a
complicated situation, due to their articular location in
the majority of cases, whose reconstruction in case of
fracture of a correct tibioastragalar articular surface
constitutes a great challenge for the surgeon. The thin
and fragile skin covering the distal part of the tibia
further complicates the therapeutic strategy for these
fractures, since it is the site of progressive suffering that
may require the open site to be removed. In this sense,
the treatment of tibial pilon fractures by closed focus
osteosynthesis (percutaneous screw fixation more or less
pinning on demand or external fixation) has an
important place in the therapeutic management of this
type of fracture (especially when they are open or
associated with significant skin damage). Closed focus
osteosynthesis, regardless of the technique used, allows
preservation of the skin, but does not allow reduction of
the fracture as is obtained with open focus
osteosynthesis. In this work, we report our experience
with a series of 13 patients with a tibial pilon fracture
treated with percutaneous screw fixation more or less
pinning on demand associated with plaster cast
immobilization for 3 to 4 weeks. This approach allowed
us to obtain anatomical reduction of the fracture in 80%
of cases, and satisfactory reduction (contact of more than
70% on either side of the fracture site as well as
reconstruction of a correct tibiotalar articular surface)
in 20% of cases. Thus, this approach allowed us to
obtain consolidation for 12 cases of fractures in an
average of 4 months with a good functional result
(average AOFAS score is 87.2).
Keywords :
Tibial pilon; fracture; percutaneous screw; plaster cast immobilisation
Fractures of the tibial pilon remain a
complicated situation, due to their articular location in
the majority of cases, whose reconstruction in case of
fracture of a correct tibioastragalar articular surface
constitutes a great challenge for the surgeon. The thin
and fragile skin covering the distal part of the tibia
further complicates the therapeutic strategy for these
fractures, since it is the site of progressive suffering that
may require the open site to be removed. In this sense,
the treatment of tibial pilon fractures by closed focus
osteosynthesis (percutaneous screw fixation more or less
pinning on demand or external fixation) has an
important place in the therapeutic management of this
type of fracture (especially when they are open or
associated with significant skin damage). Closed focus
osteosynthesis, regardless of the technique used, allows
preservation of the skin, but does not allow reduction of
the fracture as is obtained with open focus
osteosynthesis. In this work, we report our experience
with a series of 13 patients with a tibial pilon fracture
treated with percutaneous screw fixation more or less
pinning on demand associated with plaster cast
immobilization for 3 to 4 weeks. This approach allowed
us to obtain anatomical reduction of the fracture in 80%
of cases, and satisfactory reduction (contact of more than
70% on either side of the fracture site as well as
reconstruction of a correct tibiotalar articular surface)
in 20% of cases. Thus, this approach allowed us to
obtain consolidation for 12 cases of fractures in an
average of 4 months with a good functional result
(average AOFAS score is 87.2).
Keywords :
Tibial pilon; fracture; percutaneous screw; plaster cast immobilisation
