Type-C tibial plafond fractures are a challenge in trauma surgery 1-4. They are usually caused by high-energy trauma and are frequently associated with marked soft-tissue damage 5. Treatment is sometimes complicated by the presence of other injuries 6.
Conservative treatment of these fractures with traction, bracing, and immobilization in a cast rarely permits accurate reconstruction of fibular length and reduction of the articular surface of the tibial plafond. In type-C tibial plafond fractures, it is necessary to restore fibular length, anatomically reduce the articular part of the fracture to minimize the risk of secondary arthritis, and provide stable articular and metaphyseal fixation to promote fracture-healing 3,7. These goals should be achieved with a technique that is as minimally invasive as possible. Open reduction and internal fixation with plates and screws, as introduced by Ruedi and Allgower 3, and reported by several other authors to have provided good results 1,8,9, permits accurate reduction of the articular surface but with a high rate of deep infection, wound dehiscence, and soft-tissue problems 10. The use of closed reduction and percutaneous fixation techniques has reduced the incidence of wound complications 6,11. This technique is usually sufficient to reduce and stabilize the articular fragments with use of fluoroscopic or arthroscopic guidance, but it is not adequate to control the metaphyseal fragments. For these reasons, some authors have recommended surgical techniques based on closed internal fixation of the articular fracture and circular external fixation of the metaphyseal fracture 5,12-16.
Aim of the Study
The aim of this study was to review the results of fluoroscopically monitored closed reduction combined with percutaneous internal and hybrid external fixation of type-C tibial plafond fractures.
Materials and Methods
Twenty-two type-C tibial plafond fractures in …
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