The intra-articular fractures of the distal tivia extending into the ankle joint the so called tibial pilon fractures, present a challenge to the surgeon of their severity of comminution and impation.
They dsually result from vertical compression forces and rotational forces which lead to a forces which lead to a force directed through the talus into the tibial plafond.
Although historically the results of various of treatment ofthese fractures have been less than optimal, there has been a recect trend that suggests success in the majority of cases through operative treatment following the principles outlined by
the
AO/ASIF group:(1) Reconstruction of the correct length of the fibula;(2) Reconstruction of the articular surface of the tibia;(3) In troduction of a cancellous autograft to fill in the bone defect in the metaphysis of the tibia;(4) stabilization
of
the
medial aspect of the tibia by a plate, and then eraly range of motion exercises of ankle joint and delayed weight bearing.
The results oftreatment of 8 cases tibial pilon fractures exclusively treated by internal fexation following the principles of the AO/ASIF group were analysed at the Department of Orthopedic Surgery, Asan Medical Center from Oct. 1989 to fun.
1991.
@ES The results were as follows:
1. The major cause of injury was fall down(6 out of 8 cases).
2. The assocated injuries were fractures of calcaneus(2), talus(2), vertebra(1), patella(1), tarsal bones(1) and midtarsal joint disiocation(1).
3. The ipsilateral fibular fractures were combined in 5 out of 8 cases.
4. The types of fractures were type B(3 cases). type C(5 cases) according to AO/ASIF classification.
5. Open reduction and internal fixation was performed with cloverleaf plate(5 cases) and May anatomical bone plate(3 cases).
6. The good result were 5 cases and fair results were 3 cases.
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