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Updated: Apr 14 2025

Tibial Plafond Fractures

Images
  • Summary
  • Epidemiology
  • Etiology
  • Anatomy
  • Classification
  • Presentation
  • Imaging
  • Treatment
  • Techniques
  • Complications
    • Wound slough and dehiscence
      • incidence
        • 9-30%
        • wait for soft tissue edema to subside before ORIF (1-2 weeks)
      • treatment
        • free flap for postoperative wound breakdown
    • Infection
      • incidence
        • 5-15%
      • risk factors
        • significant soft tissue swelling at time of definitive surgery
        • Increasing fracture severity 
      • treatment
        • irrigation and debridement, antibiotics, possible hardware removal
    • Malunion
      • incidence
        • 6-14%
      • treatment
        • joint-preserving correction with secondary anatomic reconstruction
        • corrective ankle fusion
    • Nonunion
      • incidence
        • 5% of patients undergoing ORIF
        • usually at the metaphyseal junction
      • risk factors
        • metaphyseal comminution
        • open fractures
        • bone loss
        • tobacco use
        • NSAID use
      • treatment
        • must rule out infected non-union (labs to obtain CRP, ESR, WBC)
        • other non-union labs (PTH, calcium, total protein, serum albumin, vitamin D, TSH)
        • rigid fixation with bone grafting
    • Post-traumatic arthritis
      • incidence
        • chondrocyte cell death at fracture margins is a contributing factor
        • IL-6 is elevated in the synovial fluid following an intra-articular ankle fracture
        • most commonly begins 1-2 years postinjury
      • risk factors
        • sequalae of cartilage trauma
        • non-anatomic articular reduction
        • mal-alignment
      • treatment
        • first line is conservative management (bracing, injections, NSAIDs, activity modification)
        • total ankle arthroplasty
        • ankle arthrodesis
    • Chondrolysis
    • Stiffness 
      • Present in up to 33% at three years post-injury
      • risk factors 
        • increasing fracture severity
        • obesity
        • ASA of three or greater
    • Posterior tibial tendon entrapment
      • commonly missed
      • best visualized on preoperative CT on soft-tissue windows
      • can occur with posteromedial fracture fragments
  • Prognosis
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Trauma ⎜ Tibial Plafond Fractures (ft. Dr. Brian Weatherford)
  • Trauma
  • - Tibial Plafond Fractures
26:30 min
10/18/2019
565 plays
5.0
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(1)
Trauma⎪Tibial Plafond Fractures
  • Trauma
  • - Tibial Plafond Fractures
21:44 min
11/18/2019
1293 plays
4.8
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(9)
Foundations | Trauma | Tibial Plafond Fractures
  • Trauma
  • - Tibial Plafond Fractures
12:44 min
4/17/2025
140 plays
5.0
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(3)
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