Le fratture del pilone tibiale

Unlike usual ankle fractures, tibial pilon fractures result from high-energy trauma. Their management provides numerous challenges to the orthopaedic surgeon, including obtaining anatomic reduction of articular surface and the management of associate soft-tissue injuries. The degree of trauma to the surrounding soft-tissue envelope cannot be underestimated. Open fractures are common, and even in the absence of an open lesion, significant soft tissue damage must be appreciated in closed injuries. Treatment objectives include restoration of articular congruency and mechanical alignment, and early functional rehabilitation whilst minimising soft-tissue complications. As is apparent from the revision of the most-recent international literature, external fixation is as an effective treatment in tibial pilon fractures, as a temporary stabilization in two-steps treatment and as a definitive management for these injuries.