- See: Pilon Frx Menu
- External Fixation:
- external fixation applied medially and across the ankle can protect the articular reconstruction and prevent collapse;
- external fixation across the ankle can restore length (thru distraction) w/ or w/o fibular fixation;
- Technique of External Fixation
- 2-3 half pins are placed in the tibia;
- foot inclusion;
- one pin is placed in the medial neck of the talus;
- in most cases, distraction of the talus will effect reduction of the fibula due to their interconnecting ligaments;
- one pin is placed in the posterior calcaneus;
- circular wire fixators
- distally, first wire is transfibular (posterolateral to anteromedial);
- second wire is inserted at the posteromedial edge of the distal tibia, and exits anterolaterally;
- additional pins are placed as is necessary;
- circular wire fixators need to include fixation and distraction across the talus inorder to effect reduction of the fibula;
- otherwise plate fixation of the fibula is required in order to maintain the reduction;
- references:
- Hybrid external fixation in the treatment of the tibial plafond fractures.
- Use of an articulated external fixator for fractures of the tibial plafond.
- Intra-articular fractures of the distal tibia: surgical management by limited internal fixation and articulated distraction.
- External fixation of severely comminuted and open tibial pilon fractures.
- Pilon Fractures: Treatment with Combined Internal and External Fixation.
- The small pin circular fixator for distal tibial pilon fractures with soft tissue compromise.
- Medial external fixation with lateral plate internal fixation in metaphyseal tibia fractures. A report of eight cases with severe soft-tissue injury.
- Definitive plates overlapping provisional external fixator pin sites: is the infection risk increased?
- Butress Plating
Articulated external fixation of pilon fractures: the effects on ankle joint kinematics.
Two-staged delayed open reduction and internal fixation of severe pilon fractures.
A prospective study evaluating incision placement and wound healing for tibial plafond fractures.