Abstract

• The Intra-articular fractures of the distal tibia extending into the ankle joint, the so called tibial pilon fractures, present a Challenge to the surgeon because of their severity of comminution and impaction.
  They usually result from vortical compression forces and rotational forces which lead to a force directed through the talus into the tibial plafond.
  Although historically the results of various type of treatment of these fractures have been less than optimal, there has been a recent trend that suggests success in the majority of cases through operative treatment following the principles outlined by the AO/ASIF group ; (1)
  Reconstruction of the correct length of the fibula ; (2) Reconstruction of the articular surface of the tibia; (3) Introduction of a cancellous autograft to fill in the bone defect in the metaphysis of the tibla ; (4) Stabilization of the medial aspect of the tibia by a plate, and then early range of motion exerEises of ankle joint and delayed weight bearing.
  The results of treatment of 8 cases tibial pilon fractures exclusively treated by internal fixation following the principles of the AO/ASIF group were analysed at the Department of Orthopedic Surgery, Asan Medlcal Center from Oct. 1989 to Jun. 1991.
  The results were as follows;
  1. The major cause of injury was fall down (6 out of 8 cases).
  2. The assotated injuries were fractures of calcaneus (2), talus (2), vertebra (1). patella (1), tarsal bones (1) and mldtarsal Joint dislocation (1).
  3. The ipsilateral fibular fractures were combined in 5 out of 8 cases.
  4. The types of fractures were type B (3 cases). type C (5 cases) according to AO/ASIF Classification.
  5. Open reduction and internal fixation was peformed with cloverleaf plate (5 cases) and May anatomical bone plate (3 cases).
  6. The good results were 5 cases and fair results were 3 cases.
• Key words: Tibial Pilon Fractures, AO/ASIF principle

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