Fractures of the Ankle Joint: Investigation and Treatment Options. Goost H, Wimmer M, Barg A, Kabir K, Valderrabano V, Burger C. Evaluation of the Syndesmotic-Only Fixation for Weber-C Ankle Fractures with Syndesmotic Injury. CURRENT Diagnosis & Treatment in Orthopedics, Fourth Edition. Musculoskeletal Eponyms: Who Are Those Guys? Radiographics. Plates have been designed with concern for. During the procedure he also repaired the medial malleolus and medial aspect of the tibia were fixed. It was later modified and popularized by the Swiss orthopedic surgeon, Bernhard Georg Weber (1929-2002), in 1972 2. The distal tibia plates are made of stainless steel and are an extension of the ankle fracture management system. performed an ORIF of the distal tibial pilon fx. This classification was first described by the Belgian general surgeon, Robert Danis (1880-1962), in 1949. Usually associated with an injury to the medial side Weber C fractures can be further subclassified as 6Ĭ1: diaphyseal fracture of the fibula, simpleĬ2: diaphyseal fracture of the fibula, complexĪ fracture above the syndesmosis results from external rotation or abduction forces that also disrupt the joint Medial malleolus fracture or deltoid ligament injury often presentįracture may arise as proximally as the level of fibular neck and not visualized on ankle films, requiring knee or full-length tibia-fibula radiographs ( Maisonneuve fracture) Tibiofibular syndesmosis disruption with widening of the distal tibiofibular articulation Diagnosis is typically made through clinical evaluation and confirmed with plain radiographs. Weber B fractures could be further subclassified as 9ī2: associated with a medial lesion (malleolus or ligament)ī3: associated with a medial lesion and fracture of posterolateral tibiaĪbove the level of the syndesmosis (suprasyndesmotic) A tibial plafond fracture (also known as a pilon fracture) is a fracture of the distal end of the tibia, most commonly associated with comminution, intra-articular extension, and significant soft tissue injury. Variable stability, dependent on the status of medial structures (malleolus/ deltoid ligament) and syndesmosis may require open reduction and internal fixation (ORIF) Tibiofibular syndesmosis usually intact, but widening of the distal tibiofibular joint (especially on stressed views) indicates syndesmotic injuryĭeltoid ligament may be torn, indicated by widening of the space between the medial malleolus and talar dome Usually stable if medial malleolus intact treat with CAM Walker or Moon Boot with crutches and weight bear as tolerated with them for 6 weeksĭistal extent at the level of the syndesmosis (trans-syndesmotic) may extend some distance proximally Published by Elsevier Ltd.Below the level of the syndesmosis (infrasyndesmotic) The short-term complication rate was low.Īnkle fracture Fibular fracture Posterior malleolar fracture Posterior pilon fracture Posteromedial approach Syndesmotic injury.Ĭopyright © 2019. Albeit obtaining posterior malleolar fracture rigid fixation, syndesmotic instability was more prevalent than expected. Most fractures can be satisfactorily treated through a modified posteromedial approach. Posterior pilon variant fracture appears to be less common than previously reported. We report 2/25 (8%) patients with early wound problems and 7/25 (20%) with short-term complications during follow-up. Quality of reduction was assessed under CT scan in 19 patients, with 15/19 (78.9%) having anatomic reduction. Persistent syndesmotic instability was present in 11/25 (44%) patients after posterior malleolar stabilization. A modified posteromedial approach was used in 18/25 (72%) patients. The average age of patients was 42 years (22-62) 19/25 (76%) were female, and 6/25 (24%) were male. Twenty-five patients sustained a posterior pilon fracture, accounting for 13.4% of all operatively treated ankle fractures with median follow-up of 21.7 months. Parameters measured included age, sex, type of fracture, surgical technique, anatomical reduction, and complications. Some coders might do a double take when reading the. pilon or tibial plafond) with internal or external fixation of fibula only. Posterior pilon fracture open reduction and internal fixation. Three CPT codes describe pilon fracture treatments: 27826 - Open treatment of fracture of weight-bearing articular surface/portion of distal tibia (e.g. Twenty-five patients with posterior pilon fracture. To review a case series of patients with posterior pilon variant fracture using a novel approach, focusing on demographic data, injury pattern, surgical results based on computed tomography (CT) scan, and short-term complications.
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