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Tibial Plafond Fractures

J. Herbert Stevenson, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Tibial plafond (“pilon”) fractures involve the distal articular surface of the tibia and extend to the metaphysis.

    • Term first introduced as description of the distal tibial metaphys...

DIAGNOSIS

HISTORY

  • Obtain a detailed description of the circumstances and mechanism surrounding the inciting event (MVA, fall, skiing accident).

  • Pain

  • Edema

  • Bleeding

  • Loss of sensation/mobility

  • Assess for como...

TREATMENT

GENERAL MEASURES

  • The severity of associated soft tissue injury can influence the timing of nonsurgical/surgical treatment.

  • Nonoperative methods involve closed reduction and immobilization with...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Deep vein thrombosis (DVT) prophylaxis during hospitalization

  • Elevate affected extremity for 2 to 3 days.

  • If an external fixator is used, clean an...

REFERENCES

1
Marsh JL, Slongo TF, Agel J, et al. Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association Classification, Database and Outcomes Committee. J Orthop Trauma...

ADDITIONAL READING

  • Dujardin F, Abdulmutalib H, Tobenas AC. Total fractures of the tibial pilon. Orthop Traumatol Surg Res.  2014;100(Suppl 1):S65–S74. [View Abstract on OvidMedline]

  • Matthews S. Fr...

CODES

ICD10

  • S82.876A Nondisplaced pilon fracture of unsp tibia, init for clos fx

  • S82.873A Displaced pilon fracture of unsp tibia, init for clos fx

  • S82.874A Nondisplaced pilon fracture of right tibia, ini...

CLINICAL PEARLS

  • Tibial plafond fractures involve high-energy injuries (motor vehicle collision [MVC], fall from a height—more common in young patients) and low-energy injuries (torsional injuries from...

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