Distal Tibia Fractures

National Board of Examinations
New Delhi
Thesis protocol submission form
Ramdaspeth, Nagpur.

1.INTRODUCION
A distal metaphyseal tibia fracture is defined as fracture distal to isthmus of diaphysis and extending to the flare of distal tibia, with or without extension of the fracture to the articular surface.(59)
A pilon fracture of the tibia involves the horizontal articular surface of the distal tibia with proximal extension.(33)
Distal tibial metaphyseal fractures are often caused by high-energy axial compressive, direct bending or lowenergy rotational forces [35-36]. These fractures represent
less than 7% of all tibial fractures [38] and less than 10% of all lower extremity fractures . Specifically, metaphyseal fractures of the distal tibia comprise 15% of all fractures
of the distal third of the tibia [40].
Distal tibial fractures remain one of the most substantial therapeutic challenges   that confront the orthopaedic traumatologist. Numerous features are responsible for this, but perhaps none are as difficult as the accompanying soft tissue injury that is frequently present.(32)

Fractures of distal tibia and pilon fractures are one of the most commonly encountered fractures in orthopaedic practice. They are also one of the difficult fractures to treat on account of
1. No muscle tissue attachment on lower ¼ tibia
2. Metaphyseal cancellous comminution,
3. Most of them are compound fractures,
4. poor blood supply to the distal tibia

The thin soft tissue envelope that surrounds the distal tibia makes treatment of these fractures difficult. These fractures are often referred to as “pilon” fractures [1] or “plafond” fractures” [2] if the articular surface of the tibia is involved; in such cases an anatomic realignment of the involved articular fracture in conjunction with a stable fixation is crucial [3–7].
The main mechanisms of injury for pilon fractures are two: (1) low-energy types, secondary to rotational forces (sporting...