Le fratture del pilone tibiale: inquadramento e classificazione

Abstract

The term pilon fracture was introduced to describe these complex injuries by Destot in 1911. Their frequency is relatively low, about 1% of all lower limb fractures, with higher incidence in the 3rd and 5th decade. These fractures may be caused by falls, road accidents or sport injuries. Tibial plafond fractures may be produced by two different dynamics: shear-stress injuries, which separate bone fragments, and compression injuries, which compress and impact bony matter. Muller’s AO classification is the more complete and universally accepted system: it characterizes Type A (not articular), type B (partially articular) and type C (completely articular) fractures.

Accident dynamics, preexisting conditions of the involved part and general health status of the patient are the three anamnestic hot points. A correct sequence of evaluation, taking account of presentation, classification and soft tissue examination, turns out to be crucial in directing the surgical timing, the access and the technique adopted.

An incorrect diagnostic-therapeutic timing could produce unsatisfactory results, with variable degrees of posttraumatic arthritis and patient disability.