Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2014; 81(3):167-176 | DOI: 10.55095/achot2014/019

Distal Tibial Fractures and Pilon FracturesCurrent concepts review

E. J. Huebner^1,*, N. Iblher², D.-C. Kubosch¹, N. P. Suedkamp¹, P. C. Strohm¹

¹ Clinic for Orthopaedic and Trauma Surgery, Albert-Ludwigs-University of Freiburg, Germany

² Clinic for Hand and Plastic Surgery, Albert-Ludwigs-Universitiy of Freiburg, Germany

Fractures of the distal tibia are often very severe injuries that generally occur in the context of high-energy trauma and present with significant concomitant soft tissue involvement. Open fractures and extensive destruction of the articular surfaces are important challenges to the treating surgeon.
In consequence the outcome for distal meta- and epiphyseal tibial fractures depends largely on the severity of the soft tissue injury and its management. Conventionally, tibial pilon fractures require surgical intervention. Conservative treatment would only be considered in some exceptional cases, for example, inoperability of the patient. Controversial discussion of optimal surgical technique and optimal timing of surgery is ongoing. There is broad consensus that soft tissue consolidation must have first priority as this is the basis for both fracture healing and good long-term outcomes. Surgical intervention can be managed as a one-stage or multi-stage procedure to achieve internal or external fracture fixation.

Published: June 1, 2014  Show citation