FRACTURAS DE

PILON TIBIAL
DR DAVID TRUJILLO ESTRADA
EPIDEMIOLOGIA

 FRACTURAS DE LA METAFISIS Y EPIFISIS DEL EXTREMO DISTAL DE

LA TIBIA
 7% AL 10% DE LAS FRACTURS DE TIBIA
 MAS COMUNES EN VARONES
 EDAD PROMEDIO 30-45 AÑOS
 10% BILATERALES
 HASTA 25% FRACTURAS EXPUESTAS

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
MECANISMO DE LESION

 TRAUMATISMOS DE BAJA ENERGIA

 TRAUMATISMOS DE ALTA ENERGIA
 COMPRESION AXIAL

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
Rockwood & Green´s - Fracturas en el Adulto
LIGAMENTOS

NETTER ORTOPEDIA
COLUMNAS

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
EVALUACION CLINICA

 ESTADO DE LA PIEL Y TEJIDOS BLANDOS

 LESIONES COLUMNA
 EXTREMIDAD CONTRALATERAL
 LESIONES VASCULARES
 SINDROME COMPARTIMENTAL

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
CLASIFICACION
CLASIFICACION AO

Ao Manual of Fracture Management

Leonetti, D., & Tigani, D. (2017). Pilon fractures: A new classification system based on CT-scan. Injury, 48(10), 2311–2317.
https://doi.org/10.1016/j.injury.2017.07.026
Leonetti, D., & Tigani, D. (2017). Pilon fractures: A new classification system based on CT-scan. Injury, 48(10), 2311–2317.
https://doi.org/10.1016/j.injury.2017.07.026
CLASIFICACION TSCHERNE
ESTUDIOS DE IMAGEN

 AP, LATERAL DE TOBILLO, MORTAJA

 TAC SIMPLE Y RECONSTRUCCION 3D
TRATAMIENTO

 CONSERVADOR

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
FIJADOR EXTERNO

 RESTAURAR LA LONGITUD
 ESTABILIZAR
 NO REDUCCION ANATOMIA

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
PUNTOS DE ENTRADA FIJADOR

AO Foundation Surgery Reference

PUNTOS ENTRADA FIJADOR

AO Foundation Surgery Reference

FIJADOR EXTERNO MODULAR

AO Foundation Surgery Reference

FIJADOR EXTERNO TRIANGULAR

AO Foundation Surgery Reference

FIJADOR EXTERNO HIBRIDO

AO Foundation Surgery Reference

FIJADOR EXTERO HIBRIDO

AO Foundation Surgery Reference

FIJADOR EXTERNO - ILIZAROV

AO Foundation Surgery Reference

FIJADOR EXTERNO ILIZAROV

AO Foundation Surgery Reference

INTERVALO QUIRURGICO

 ¿7 A 14 DIAS?
 EDEMA
 NECROSIS
 FLICTENAS

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
ABORDAJE ANTEROLATERAL

AO Foundation Surgery Reference

ABORDAJE ANTEROMEDIAL
ABORDAJE POSTEROMEDIAL

AO Foundation Surgery Reference

TRATAMIENTO QUIRURGICO 43-A

 ¿FIJADOR EXTERNO TEMPORAL?

 TAMAÑO FRAGMENTO EPIFISIARIO
 ¿FIJACION PERONE?

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8
OSTEOSINTESIS 43-A

AO Foundation Surgery Reference

TECNICA CLAVO CENTROMEDULAR
43-A

AO Foundation Surgery Reference

REDUCCION

AO Foundation Surgery Reference

TECNICA PLACA
MINIMAMENTEINVASIVA 43-A

AO Foundation Surgery Reference

TECNICA PLACA
MINIMAMENTEINVASIVA 43-A

AO Foundation Surgery Reference

TECNICA QUIRURGICA FRACTURAS
43-B1

AO Foundation Surgery Reference

TECNICA QUIRURGICA 43-B

AO Foundation Surgery Reference

FRACTURAS 43-B2

AO Foundation Surgery Reference

FRACTURAS 43-B2

AO Foundation Surgery Reference

FRACTURAS 43-C

 1 ETAPA, 2 ETAPAS, 3 ETAPAS

 ¿ABORDAJE?
 VARO-VALGO

AO Foundation Surgery Reference

IMPACTACION ARTICULAR

AO Foundation Surgery Reference

FRACTURAS 43-C

AO Foundation Surgery Reference

FRACTURAS 43-C

AO Foundation Surgery Reference

FRACTURAS 43-C

AO Foundation Surgery Reference

FRACTURAS 43-C

AO Foundation Surgery Reference

FRACTURAS 43-C

AO Foundation Surgery Reference

RECUPERACION

 MANTENER ELEVADA EXTREMIDAD EN LOS PRIMEROS 5 DIAS

 SEGUIMIENTIO RADIOGRAFICO A LAS 2, 6 Y 12 SEMANAS
 12 SEMANAS INICIA CARGA COMPLETA
 RETIRO DE IMPLAMNTES A LOS 12 MESES

AO Foundation Surgery Reference

COMPLICACIONES

 PSEUDOARTROSIS
 RETRASO DE CONSOLIDACION
 ARTROSIS
 INFECCION

Zelle, B. A., Dang, K. H., & Ornell, S. S. (2019). High-energy tibial pilon fractures: an instructional
review. International orthopaedics, 43(8), 1939–1950. https://doi.org/10.1007/s00264-019-04344-8