The Orthobullets Podcast Trauma | Tibial Plafond Fractures
Sep 10, 2025
Dive into the intricacies of tibial plafond fractures! Explore the mechanisms behind these injuries and the various diagnostic techniques. The discussion highlights both surgical and non-surgical treatment strategies. Engage with case-based questions that reinforce learning and clarify the complexities of managing these fractures. It's a must-listen for anyone keen on trauma orthopedics!
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Pilon Fractures Are High-Energy, Complex Injuries
- Tibial plafond (pilon) fractures are distal tibia injuries with frequent comminution, intraarticular extension, and severe soft-tissue damage.
- These features make diagnosis by x-ray straightforward but treatment and prognosis more complex than simple ankle fractures.
Mechanism Explains Severe Soft-Tissue Injury
- These fractures typically result from high-energy axial loads where the talus is driven into the plafond, such as falls from height or MVAs.
- Expect severe pain, swelling, deformity, fracture blisters, possible open wounds, and need for a thorough neurovascular and compartment exam.
Image Broadly And Identify Key Fragments
- Obtain AP, lateral, mortise, and full-length tibia/fibula and foot x-rays to assess articular extension and fracture fragments.
- Recognize the four classic fragments: medial malleolus, anterior (Chaput), lateral (Wagstaff), and posterior (Volkmann) fragments for planning surgery.