Tibial pilon fractures: management and evaluation of the outcome in mean and long term about 51 cases
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20242373Keywords:
Ankle arthrosis, Osteosynthesis, Screwed plate, Tibial pilon, FracturesAbstract
Background: the management of tibial pilon fractures is a real challenge in our regions.
Methods: This was a mixed study: dynamic from January 1 to December 31, 2013 involving 19 patients; retrospective from January 1, 2014 to December 31, 2018, covering 32 patients, received, treated and followed up for tibial pilon fracture in the Orthopedics-Traumatology department of the Donka university hospital center, Conakry Republic of Guinea. The clinical diagnosis was guided by the pain, functional impotence, a context of high trauma energy and confirmed by the X-ray of the ankle in antero-posterior and lateral views. The AO (association for Osteosynthesis) classification was used in our department.
Results: The average age was 36.21 years old with male predominance, the sex ratio was 5.4. The road accidents were the mostly found (86.27%). The motorbicycles were the mostly involved; the osseous lesions the mostly found were the type C according to AO classification (56.86%), followed by type B (33.33%). The orthopaedical treatment (27.45%), and surgical (72.55%). The ankle arthrosis was the most complication found (27.45%).
Conclusions: Tibial pilon fractures are rare but serious however the treatment depends on the anatomopathological type. The prognosis of these lesions remains always reverved in our context of lack of equipment in our hospitals.
References
Sahnoun N, Naiefar W, Rekik MA, Tarek B, Abid A, Keskes H. Etude rétrospective de 50 cas de fractures du pilon tibial chez l'adulte au Service d'Orthopédie du Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisie. J Méd Panafricain. 2021;39:223.
Wei SJ. Surgical treatment of pilon fracture based on ankle position at the time of injury/initial direction of fracture displacement: A prospective cohort study. Int J Surg. 2014;12(5):418-25.
Bourne RB. Pylon fractures of the distal tibia. Clin Orthop Related Res. 1989;42-6.
Mauffrey C, Vasario G, Battiston B, Lewis C, Beazley J, Seligson D. Tibial pilon fractures: a review of incidence, diagnosis, treatment, and complications. Acta Orthopaedica Belgica. 2011;77:432-40
Mandi DM, Belin RP, Banks J, Barrett B. Pilon fractures. Clin Podiatr Med Sur. 2012;29:243-78.
Crist BD, Khazzam M, Murtha MYM, Della Rocca GJ. Pilon fractures: advances in surgical management. JAAOS. 2011;19:12-22.
Jun-Hong Liu J-H. Analysis of the ability of a distal tibial anatomical locking plate to capture the distaltibial fragments in patients with pilon fractures. Orthop Surg. 2023;9999.
Fischer B, Mason LW. Reconstruction of Severe Ankle and Pilon Fracture Malunions. Foot Ankle Clin. 2020;25:221-37.
Lahrach K, Boutayeb F. Résultats du traitement chirurgical des fractures du pilon tibial-à propos de 50 cas. Rev Chir Orthopédique Traumatol. 2014;100(7):303-4.
Yang K, Shen G, Zheng Q, Yang H, Zhang H, Li X, et al. Medial malleolar window approach for varus type tibial pilon fractures: a retrospective study. BMC Musculoskeletal Disorders. 2023;24:358.
Yu Zhao Y. Surgical approach strategies for open reduction internal fixation of closed complex tibial Pilon fractures based on axial CT scans. J Orthop Surg Res. 2020;15:283.
Lahrach K, Loudyi D, Bennani A, Daoudi A, E.l Mrini A, Boutayeb F. Traitement chirurgical des fractures du pilon tibial (à propos de 39 cas). Rev Maroc Chir Orthop Traumato. 2009;39:24-8
13. Découlx P, Razemon J-P,Rousselle Y. Fractures du pilon tibial, Rev Chir Orthop 1961;47:563-77.
Ruedi Tp, Allgower M. The operative treatment of intra-articular fractures the lower end of the tibia. Clin Orthop. 1979;138:105-10.
Arlettaz Y, Blanc C.H, Chevalley F. Les fractures du pilon tibial, étude rétrospective à long terme de 51 fractures traitées par réduction sanglante et ostéosynthèse. Rev Chir Orthop. 1998;84:180-8.
Chaudhry YP, Papadelis E, Hayes H, Stahel PF, Hasenboehler EA. Fusion versus fixation in complex Comminuted C3-type tibial pilon fractures: a systematic review. Patient Safety Surg. 2021;15:35.
