Abstract

• The tibial plafond fractures result from an axial compression and rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displacement, it is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws, basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The author analysed the 22 cases of the tibial plafond fractures in 22 patients, which were treated at the department of orthopedic surgery in Dai Han hospital. From january 1989 to january 1991. The longest duration of follow up was 2 years and 6 months and shortest one was 7 months, and the average was 14 months The results were as follows ; 1. Among the 22 patients, male were 17 and female was five. 2. The major causes of injury were a fall from a height. 3. Regardless of the method of treatment the type I and II were In good and fair result, but the type III were fair in 4 cases and poor in 2 cases, other 5 cases were in good result. 4. It is important to remind the basic steps in reconstruction appllied in an indivisual case especially in type III. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, early motion of the ankle joint is possible. The early motion reduces stiffness of the ankle and will yeild the most satisfying rusult. But the anatomic reduction of ankle joint is difficult to be obtained in each case especlally in type III and may consider an ankle fusion.
• Key words: Fracture, Tibla plafond

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