Direct fixation of fractures of the posterior pilon via a posteromedial approach

Abstract The treatment of fractures of the posterior pilon is a timely issue. Restoration of the integrity of the incisura fibularis and subsequent anatomic reduction of the fibula are essential for reconstruction of the ankle mortise after trauma, and syndesmotic stability. Inappropriate treatment...

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Bibliographic Details
Published in:Injury 2017-06, Vol.48 (6), p.1269-1274
Main Authors: Hoekstra, H, Rosseels, W, Rammelt, S, Nijs, S
Format: Article
Language:English
Subjects:
Ankle
Ankle Fractures - physiopathology
Ankle Fractures - surgery
Fibula - injuries
Fixation
Fracture
Fracture Fixation, Internal - methods
Fractures, Comminuted - physiopathology
Fractures, Comminuted - surgery
Guidelines as Topic
Humans
Open Fracture Reduction - methods
Orthopedics
Patient Positioning
Posterior malleolus
Treatment Outcome
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Summary:Abstract The treatment of fractures of the posterior pilon is a timely issue. Restoration of the integrity of the incisura fibularis and subsequent anatomic reduction of the fibula are essential for reconstruction of the ankle mortise after trauma, and syndesmotic stability. Inappropriate treatment ultimately will lead to a poor functional outcome and quality of life. Open reduction and direct internal fixation through a posterolateral or posteromedial approach are increasingly preferred over indirect reduction and anteroposterior screw fixation. The posteromedial approach, although elegant, straightforward, and offering an excellent exposure of the fracture site, is used less frequently than the posterolateral approach. In this technical note we describe the posteromedial approach for the treatment of posterior pilon fractures in a step-by-step fashion. We will discuss the indications, its benefits and limitations.
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2017.03.016