Management of Pilon Fractures—Current Concepts
Tibial pilon fractures were first described by Étienne Destot in 1911. He used the French word “pilon” (i.e., pestle), to describe the mechanical function of the distal tibia in the ankle joint. This term has further been used to portray the mechanism involved in tibial pilon fractures in which the...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-12-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2021.764232/full |
| _version_ | 1818971170096021504 |
|---|---|
| author | Olivia Mair Patrick Pflüger Kai Hoffeld Kai Hoffeld Karl F. Braun Karl F. Braun Chlodwig Kirchhoff Peter Biberthaler Moritz Crönlein |
| author_facet | Olivia Mair Patrick Pflüger Kai Hoffeld Kai Hoffeld Karl F. Braun Karl F. Braun Chlodwig Kirchhoff Peter Biberthaler Moritz Crönlein |
| author_sort | Olivia Mair |
| collection | DOAJ |
| description | Tibial pilon fractures were first described by Étienne Destot in 1911. He used the French word “pilon” (i.e., pestle), to describe the mechanical function of the distal tibia in the ankle joint. This term has further been used to portray the mechanism involved in tibial pilon fractures in which the distal tibia acts as a pestle with heavy axial forces over the talus basically causing the tibia to burst. Many different classification systems exist so far, with the AO Classification being the most commonly used classification in the clinical setting. Especially Type C fractures are extremely difficult to manage as the high energy involved in developing this type of injury frequently damages the soft tissue surrounding the fracture zone severely. Therefore, long -term outcome is often poor and correct initial management crucial. In the early years of this century treatment has evolved to a two–staged protocol, which nowadays is the gold standard of care. Additional methods of treating the soft tissue envelope are currently being investigated and have shown promising results for the future. The aim of this review is therefore to summarize protocols in managing these difficult fractures, review the literature on recent developments and therefore give surgeons a better understanding and ability to handle tibial pilon fractures. |
| first_indexed | 2024-12-20T14:48:07Z |
| format | Article |
| id | doaj.art-9217d7b1c10f4067a59307b9440f89af |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-20T14:48:07Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-9217d7b1c10f4067a59307b9440f89af2022-12-21T19:37:04ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2021-12-01810.3389/fsurg.2021.764232764232Management of Pilon Fractures—Current ConceptsOlivia Mair0Patrick Pflüger1Kai Hoffeld2Kai Hoffeld3Karl F. Braun4Karl F. Braun5Chlodwig Kirchhoff6Peter Biberthaler7Moritz Crönlein8Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyCenter for Orthopedic and Trauma Surgery, University Medical Center, Cologne, GermanyDepartment of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Trauma Surgery, Center for Musculoskeletal Surgery, Charité University Medicine Berlin, Berlin, GermanyDepartment of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyTibial pilon fractures were first described by Étienne Destot in 1911. He used the French word “pilon” (i.e., pestle), to describe the mechanical function of the distal tibia in the ankle joint. This term has further been used to portray the mechanism involved in tibial pilon fractures in which the distal tibia acts as a pestle with heavy axial forces over the talus basically causing the tibia to burst. Many different classification systems exist so far, with the AO Classification being the most commonly used classification in the clinical setting. Especially Type C fractures are extremely difficult to manage as the high energy involved in developing this type of injury frequently damages the soft tissue surrounding the fracture zone severely. Therefore, long -term outcome is often poor and correct initial management crucial. In the early years of this century treatment has evolved to a two–staged protocol, which nowadays is the gold standard of care. Additional methods of treating the soft tissue envelope are currently being investigated and have shown promising results for the future. The aim of this review is therefore to summarize protocols in managing these difficult fractures, review the literature on recent developments and therefore give surgeons a better understanding and ability to handle tibial pilon fractures.https://www.frontiersin.org/articles/10.3389/fsurg.2021.764232/fulltibial pilon fracturesdistal tibial fracturesankle fracturessoft tissue managementtibia–injuries |
| spellingShingle | Olivia Mair Patrick Pflüger Kai Hoffeld Kai Hoffeld Karl F. Braun Karl F. Braun Chlodwig Kirchhoff Peter Biberthaler Moritz Crönlein Management of Pilon Fractures—Current Concepts Frontiers in Surgery tibial pilon fractures distal tibial fractures ankle fractures soft tissue management tibia–injuries |
| title | Management of Pilon Fractures—Current Concepts |
| title_full | Management of Pilon Fractures—Current Concepts |
| title_fullStr | Management of Pilon Fractures—Current Concepts |
| title_full_unstemmed | Management of Pilon Fractures—Current Concepts |
| title_short | Management of Pilon Fractures—Current Concepts |
| title_sort | management of pilon fractures current concepts |
| topic | tibial pilon fractures distal tibial fractures ankle fractures soft tissue management tibia–injuries |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2021.764232/full |
| work_keys_str_mv | AT oliviamair managementofpilonfracturescurrentconcepts AT patrickpfluger managementofpilonfracturescurrentconcepts AT kaihoffeld managementofpilonfracturescurrentconcepts AT kaihoffeld managementofpilonfracturescurrentconcepts AT karlfbraun managementofpilonfracturescurrentconcepts AT karlfbraun managementofpilonfracturescurrentconcepts AT chlodwigkirchhoff managementofpilonfracturescurrentconcepts AT peterbiberthaler managementofpilonfracturescurrentconcepts AT moritzcronlein managementofpilonfracturescurrentconcepts |