Orthopedics

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By P. Bartolozzi

Fractures of the tibial pilon (plafond) characterize one of the most invalidating articular lesions. This quantity describes the anatomic and radiological type of those fractures and discusses modern remedies. For tibial pilon fractures in adults, the authors illustrate the excellence among closed lesions and lesions concerning gentle tissue publicity and trauma, and describe different ideas. Tibial fractures in formative years also are mentioned, particularly in regards to the risk of next deformity. the amount might help readers comprehend the explanation for a number of the healing offerings in addition to the modalities of executing those techniques.

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Additional resources for Fractures of the Tibial Pilon

Sample text

It can restore length to the damaged bone segment and correct the tension in the ligament-capsule complex. Another characteristic of these fractures is that the mean patient age is 35-40. Clearly unsuitable treatment will have consequences leading to invalidity, and complications can arise even after a "successful" operation [3-51. It is widely held in traumatology that anatomical reduction of the articular surface should be achieved, as far as possible, in these types of fractures, to provide long-term stability and more rapid return to joint mobility.

In fact, in the older adolescent, malleolar fractures can occur, but usually when the growth plates have closed, which puts them outside the paediatric range. Bi- or uni-malleolar fractures, more commonly of the tibial malleolus, may occur in the presence of open growth plates, but overall, indications for surgery are rare and do not present any real differences from adult cases. Regarding radiology, it should be remembered that the nuclei of distal tibial and fibular ossification do not appear before 12-18 months, and fuse with the metaphysis at 16-20 years (the fibular nucleus second) [2].

On the other hand, the role of MRI is of the highest importance in acute injuries not visible to conventional radiology, bone contusion and lesions caused by repeated micro-trauma and stress fractures. In distorsive lesions, imaging plays a somewhat limited role, but is of great help in identifying elementary lesions that are the basis of chronic post-traumatic instability. References 1. 2. 3. 4. Zimmer TJ (1991) Chronic and recurrent ankle sprains. Clin Sports Med 10(3):653-659 Cheung Y, Rosenberg ZS (2001) MR imaging of ligamentous abnormalities of the ankle and foot.

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