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Emergency Med/Trauma > Pilon Fractures > Flashcards

Pilon Fractures Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

A fracture involving the distal tibial metaphysis with extension into the ankle

A

Pilon fracture definition

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2
Q

What are the two types of Pilon fractures?

A

Low energy rotational

High energy axial

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3
Q

High energy force pilon fracture is usually caused by what?

A

The talus impacting the distal portion of the tibia

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4
Q

Explain the importance of addressing the fibula

A

If the fibula is fractured, then it is important to correct this and bring it back to length. This allows you to build the tibia to correct length

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5
Q

Type 1 Ruedi and Allgower pilon fracture

A

Pilon fracture without displacement

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6
Q

Type 2 Ruedi and Allgower pilon fracture

A

Pilon fracture with significant displacement

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7
Q

Type 3 Ruedi and Allgower pilon fracture

A

Pilon fracture involving comminution, displacement, and impaction

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8
Q

Tscherne classification is used for damage to what?

A

Soft tissue

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9
Q

Tscherne Grade 0

A

Minimal soft tissue injury

Indirect injury

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10
Q

Tscherne Grade 1

A

Superficial abrasion or contusion

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11
Q

Tscherne Grade 2

A

Deep abrasion with local skin and muscle contraction

Direct injury

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12
Q

Tscherne Grade 3

A

Extensive contusion and crushing of skin and muscle

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13
Q

What are 4 indications for surgery?

A

Open fractures
Compartment syndrome
Joint space incongruity greater than 2 mm
Malalignment greater than 5 degrees

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14
Q

What is the zone of injury

A

This involves the actual area of injury. An ankle fracture could have a zone of injury that extends more proximal or distally

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15
Q

Describe a single stage treatment approach for a low energy rotation fracture

A

Stabilize with compression and then ORIF when soft tissue is stable

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16
Q

Describe a single stage treatment approach for a high energy axial fracture

A

Apply external fixation w/ or w/o internal fixation. Utilize biological fracture management

17
Q

What is the role of Ex-fix

A

Prevent soft-tissue contracture
Easy access to wounds
Can be temporary or definitive procedure

18
Q

Tibial half pins should not interfere with what?

A

They should not interfere with possible incision placement

19
Q

Explain stage 1 of a multi-stage procedure

A

Stabilize limb with spanning ex-fix and debride soft tissue as needed

20
Q

Explain stage 2 of a multi-stage procedure

A

This provides the definitive treatment.

  • ORIF
  • Soft tissue coverage

Emergency Med/Trauma (26 decks)

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