Pilon Fractures Flashcards Preview

Emergency Med/Trauma > Pilon Fractures > Flashcards

Flashcards in Pilon Fractures Deck (20)
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1
Q

A fracture involving the distal tibial metaphysis with extension into the ankle

A

Pilon fracture definition

2
Q

What are the two types of Pilon fractures?

A

Low energy rotational

High energy axial

3
Q

High energy force pilon fracture is usually caused by what?

A

The talus impacting the distal portion of the tibia

4
Q

Explain the importance of addressing the fibula

A

If the fibula is fractured, then it is important to correct this and bring it back to length. This allows you to build the tibia to correct length

5
Q

Type 1 Ruedi and Allgower pilon fracture

A

Pilon fracture without displacement

6
Q

Type 2 Ruedi and Allgower pilon fracture

A

Pilon fracture with significant displacement

7
Q

Type 3 Ruedi and Allgower pilon fracture

A

Pilon fracture involving comminution, displacement, and impaction

8
Q

Tscherne classification is used for damage to what?

A

Soft tissue

9
Q

Tscherne Grade 0

A

Minimal soft tissue injury

Indirect injury

10
Q

Tscherne Grade 1

A

Superficial abrasion or contusion

11
Q

Tscherne Grade 2

A

Deep abrasion with local skin and muscle contraction

Direct injury

12
Q

Tscherne Grade 3

A

Extensive contusion and crushing of skin and muscle

13
Q

What are 4 indications for surgery?

A

Open fractures
Compartment syndrome
Joint space incongruity greater than 2 mm
Malalignment greater than 5 degrees

14
Q

What is the zone of injury

A

This involves the actual area of injury. An ankle fracture could have a zone of injury that extends more proximal or distally

15
Q

Describe a single stage treatment approach for a low energy rotation fracture

A

Stabilize with compression and then ORIF when soft tissue is stable

16
Q

Describe a single stage treatment approach for a high energy axial fracture

A

Apply external fixation w/ or w/o internal fixation. Utilize biological fracture management

17
Q

What is the role of Ex-fix

A

Prevent soft-tissue contracture
Easy access to wounds
Can be temporary or definitive procedure

18
Q

Tibial half pins should not interfere with what?

A

They should not interfere with possible incision placement

19
Q

Explain stage 1 of a multi-stage procedure

A

Stabilize limb with spanning ex-fix and debride soft tissue as needed

20
Q

Explain stage 2 of a multi-stage procedure

A

This provides the definitive treatment.

  • ORIF
  • Soft tissue coverage