Review Question - QID 979

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Tibial Plafond Fractures Treatment Operative QID: 979 (OBQ05.93)

QID 979 (Type "979" in App Search)

A 32-year-old man sustains a pilon fracture which is treated initially with a spanning external fixator, as shown in figure A. He is now 3 weeks from injury and skin swelling has subsided significantly. What is the most appropriate definitive treatment?

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open reduction internal fixation of the fibula only

15/1867

open reduction internal fixation of the tibia and fibula

98%

1824/1867

removal of external fixator and conversion to a walking cast

10/1867

dynamization of the external fixator

6/1867

tibio-talar arthrodesis

4/1867

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External fixation is a temporizing treatment that allows the soft tissues to return to normal while maintaining your overall alignment. A fibular plate can help keep the length. Final treatment involves restoration of the tibial plafond articular surface which can only be done with ORIF +/- bone grafting. There is no role for primary arthrodesis in this young patient.

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