Fratura do pilão tibial

tratamento cirúrgico aberto pela via ântero-lateral e acesso minimamente invasivo medial

Authors

  • Wellington Farias Molina Hospital do Servidor Estadual de São Paulo
  • Matheus de Paula Oliveira Hospital do Servidor Estadual de São Paulo
  • João Victor Bazílio Beccali Hospital do Servidor Estadual de São Paulo
  • Guilherme Bottino Martins Hospital do Servidor Estadual de São Paulo
  • Luiz Sérgio Martins Pimenta Hospital do Servidor Estadual de São Paulo

Keywords:

pilon fracture, tibial plafond fracture, surgical approaches, soft tissue injury

Abstract

Although tibial pilon fractures are infrequent, representing only approximately 1% of lower limb fractures, their treatment requires special attention. They are intra-articular fractures of the distal third of the tibia with metaphyseal extension, which result from high or low energy trauma. The trauma mechanism arises from an axial load applied to the foot, generating different fracture patterns depending on its position at the time of trauma. In addition, different degrees of damage may occur to the soft tissue, and its management is of fundamental importance for satisfactory outcomes. Treatment of these complex fractures has evolved substantially in recent decades, with a staged approach being an important part of this progress (initially external fixation, with subsequent definitive synthesis after improvement in the soft tissue condition), as well as adequate osteosynthesis.

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Author Biographies

Wellington Farias Molina, Hospital do Servidor Estadual de São Paulo

Chefe do Grupo de Cirurgia do Pé e Tornozelo do Serviço de Ortopedia e Traumatologia do HSPE, São Paulo, SP, Brasil

Matheus de Paula Oliveira, Hospital do Servidor Estadual de São Paulo

Médico Residente (R3) do Serviço de Ortopedia e Traumatologia do HSPE, São Paulo, SP, Brasil

João Victor Bazílio Beccali, Hospital do Servidor Estadual de São Paulo

Médico Residente (R4) do Grupo de Cirurgia do Pé e Tornozelo do Serviço de Ortopedia e Traumatologia do HSPE, São Paulo, SP, Brasil

Guilherme Bottino Martins, Hospital do Servidor Estadual de São Paulo

Médico Assistente do Grupo de Cirurgia do Pé e Tornozelo do Serviço de Ortopedia e Traumatologia do HSPE, São Paulo, SP, Brasil

References

Sommer C, Baumgaertner MR. Tíbia, distal intra-articular (pilão). In: Princípios AO do tratamento de fraturas, Ruedi TP,Buckley RE, Moran CG. 2. ed. Porto Alegre: Artmed, 2009.

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Pimenta LSM, Costa ARF, Baptista MV, Daher SS. Fraturas do pilão tibial: avaliação do tratamento em 25 pacientes. Rev Bras Ortop. 1997;32(7): 497-502

Hebert-Davies J, Kleweno CP, Nork SE. Contemporary Strategies in Pilon Fixation. J Orthop Trauma. 2020 Feb;34 Suppl 1:S14-S20.

Assal M, Ray A, Stern R. Strategies for surgical approaches in open reduction internal fixation of pilon fractures. J Orthop Trauma. 2015 Feb;29(2):69-79.

Zelle BA, Dang KH, Ornell SS. High-energy tibial pilon fractures: an instructional review. Int Orthop. 2019 Aug;43(8): 1939-1950.

Published

2021-03-20

How to Cite

1.
Molina WF, Oliveira M de P, Beccali JVB, Martins GB, Pimenta LSM. Fratura do pilão tibial: tratamento cirúrgico aberto pela via ântero-lateral e acesso minimamente invasivo medial. RTO [Internet]. 2021 Mar. 20 [cited 2024 Nov. 21];21(2):16-22. Available from: https://rto.emnuvens.com.br/revista/article/view/144

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