According to the four-column classification scheme, lateral column of 85 cases, posterior column of 66 cases, medial column of 77 cases, and anterior column of 61 cases are involved. Fractures were classified by six evaluators (three foot and ankle surgeons and three orthopaedic surgery residents) using CT scans according to the morphological grading of the new pilon fracture classification system developed by Leonetti et al. In: OrthopaedicsOne - The Orthopaedic Knowledge Network. Background Distal tibia fracture with intra-articular extension . KEY FACTS • The tibial pilon fracture is a rare, yet devastating injury. Despite the best treatment, patients sustaining high-energy pilon fractures generally do not return to their previous state of general health or function. There is no commonly used classification of pilon fractures, but a simple classification is that of Ruedi & Allgower: Type I: undisplaced; Type II: displaced but not comminuted The new classification system was simple, all inclusive and easily to remember. In the AO/OTA classification for long bone fractures, pilon fractures are classified as extra-articular (43A), partial articular (43B), and intra-articular (43C), and further subclassified based on the degree of comminution. Pilon (tibial plafond) fractures - Ruedi and Allgower classification. Type-III fractures are the most frequent presentation, comprising approximately 25% to 71% of all pilon fractures. In 2017, Leonetti and Tigani published a new classification system of pilon fractures based on CT. 236. Retrieved Source. Like Neer classification for proximal humerus fractures, this classification divides the pilon fracture in 4 groups according to the number of the fragments at the joint level. The pilon fracture was first described by Destot (1) in 1911. Created Apr 04, 2012 02:40. Pilon Fractures Philip Wolinsky . A pilon fracture involves the distal tibial metaphysis with extension… Plain XR and CT of a displaced comminuted pilon fracture. OrthopaedicsOne Articles. – Determined by fracture pattern and “primary” injury Pilon Fractures • Post‐op Care – Make it protocol – Strict elevation post‐op: 23 hrs/day “The operative treatment of intra-articular fractures of the lower end of the tibia.” Clin Orthop Relat Res (138): 105-110. This article addresses pilon fractures—a specific type of fracture that occurs in the lower leg near the ankle. Pilon Fractures • Approaches & Technique – Beyond this scope – Anteromedial, anterolateral, posterior, anterior, perc, MIPO, percwith IMN, ringed fixation, etc. After recovery from pilon fractures, many patients continue to … Pilon Fractures George S. Gumann Justin J. Fleming The opinions of the authors are their private views and are not to be considered as representative of official policy of the U.S. Army Medical Department. University of California at Davis Medical Center . The CT shows the five common fragments (anterior, posterior, medial, anterolateral and die-punch). METHODS: One hundred and ten cases (107 patients) of Pilon fractures classified by the four-column theory and treated by ORIF, were reviewed. Reference: Ruedi, T. P. and M. Allgower (1979). The new system divides pilon fractures according to 4 labeling factors: 1) if the articular surface is involved, 2) the number of articular fragments, 3) the direction of major fracture line, and 4) areas of comminution. Last modified Apr 05, 2012 09:33 ver. 20-25% are open . 1/3 of patients have associated injuries . Spectrum of injuries: 1) Low energy rotational fx’s Ankle type fractures / Skiing, simple falls . 1-10% of LE fx’s . 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