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Tibial Plafond Fracture Treatment | Tibial Plafond Bone Fracture Surgery, Recovery, Healing Time and Symptoms

23 Sep

There can be many forms of ankle injury. Each of them has their own areas that are affected. When there are two malleoli that are cracked or broken, the ankle fracture is called as the bimalleolar fracture. On the other hand, when the two malleoli and the posterior process in the tibial area are affected then it is already called the trimalleolar fracture. However, when it already affects the shin bone and the ankle joint then that is a different kind of fracture. This is what they call as the plafond fracture.

In this article, we will talk about this kind of fracture of the ankle and other important details that go with it. All these information and details would be vital in better understanding the nature of the fracture, how to heal it and what other important details should we know about it.

Definition of tibial plafond fracture

The tibial plafond fracture is another form of ankle fracture. This condition affects the tibial plafond or the shin bone of the ankle and the ankle joint. This is also known as the tibial pilon fracture.  Pilon is a term for hammered. This is also called as such because this tibial plafond bone fracture occurs due to the clash of the end of the shin bone and the ankle joint. Thus, when there is a hammering instance between these two bones, tibial plafond fractures happen. Basically, the tibial plafond definition can be shortened as the hammering of two parts in the ankle region.

This is entirely different from the other fractures of the ankle such as the bimalleolar ankle fracture and trimalleolar ankle fracture because it does not affect the malleoli parts. As mentioned, fractured tibial plafond only affects the end of the shin bone and the ankle joint during the clash of these two parts of the ankle region. To be able to understand the difference of these three types of ankle breaks, it would be best to research first on the anatomy of the human ankle. After which, it would already be easier to differentiate one form from the other.

Causes of tibial plafond fracture

There can actually be many causes of the distal tibial plafond fracture. However, the following are the most common causes of this kind of fracture:

  • Vehicular accidents – sudden impact on the ankle region during these instances would cause the fracture,
  • Falling on feet – this is more possible to happen when a person falls from a great height wherein his feet are the first part that falls on the ground. This instance results to the collisions of the bones.

Symptoms of tibial plafond fracture

Just like any other forms of fracture, the following the fracture symptoms for this type of ankle fracture:

  • Pain
  • Swelling
  • Difficulty to walk
  • Affected area becomes tender to touch
  • Deformity (when the fracture is already at its worst condition)


Different classification of tibial plafond fracture

There are certain tibial fracture classifications. Each of the classification is important to understand so that the proper medication and procedure can be performed for the affected individual. Here are the following:

  • Type 1: mild fracture; the broken tibial plafond bone is still aligned and congruous. There is only a mild crack on the affected area.
  • Type 2: moderate fracture; the fractured ankle is still aligned and there is a mild incongruence on the joint surface. There can be misalignment of the affected area but it is not too severe to cause deformity.
  • Type 3: severe fracture; the fractured ankle is not anymore aligned and there is a total misalignment of the joint surface. This would even have severe swelling and at times causes an open fracture.


Diagnosing tibial plafond fracture

Just like any other forms of fracture, the best way to diagnose a fracture is through an X-ray procedure. It is through this procedure that one would identify the condition of the fracture and what the necessary procedures on how to treat ankle fracture quick. At times, a CT scan would be more preferred to really identify the severity of the tibial plafond injury and what the necessary procedures that a person should undergo.


Preliminary procedures for treating an ankle fracture

When faced with a bone fracture, the immediate action that one has to perform is to immobilize the affected area. This would avoid any fracture complications and would even lessen the pain that one would suffer from the fracture. At the same time, ice medication or taking in some medicines that would relieve the pain or inflammation of the affected area would be helpful during the early stage of treating the distal tibial plafond fracture.

Types of treatment for tibial plafond fracture

  • Nonsurgical

Nonsurgical procedures include the use of fracture cast and traction. This is only applicable to individuals who are suffering from type 1 and 2 of tibial plafond fracture. This can also be considered for people who do not have the ability to withstand a surgical procedure in the tibia plafond due to different reasons.

The use of brace/braces is applicable when there is still congruence on the joint surface. On the other hand, the use of traction or the application of force on the suffering part is best for patients who cannot handle a surgical procedure under certain circumstances. The recovery time for both methods would depend on the capability of the individual. There are also home treatments that can help in cutting the tibial plafond fracture recovery time short.

  • Surgical

There are also different forms of tibial plafond fracture surgery procedures. Here are as follows:

  • External fixation: This is best for patients who are suffering from type 2 and 3 tibial plafond fracture. This is considered when the skin does not look good and there is swelling. It may also be considered when the swelling has already subsided depending on the health condition and background of the patient.
  • Internal fixation: This is used when the patient is suffering from either type 2 or 3 tibia fractures. This is made through the use of screws and rods that are inserted on the ankle to realign the fractured ankle from the inside. This can only be considered when there is no swelling and the condition of the patient can entertain such intrusion.
  • Limited internal fixation: This is considered when the patient needs internal fixation due to the damage in the ankle but the soft-tissues cannot stand the full internal fixation process. This method is performed by creating small incisions enough to insert rods and screws that can somehow help in the alignment of the broken ankle from the inside. Then, it is supported by external brace/braces.
  • Ankle fusion: This is a new method in treating ankle injuries and is only performed when the tibial plafond fracture is already on its worst case and returning the normal function of the ankle is already impossible. This provides a stable platform that can help in giving the patient with less pain while walking.

After following the necessary and advised surgical procedures for this type of fracture, it would also be necessary to undergo a rehabilitation to ensure that the ankle is really back on its normal function. This is especially true for patients that would need to go through the ankle fusion procedure so that they can fully adapt to the use of the platform. This rehab period would include exercises to test the full recover of the fractured ankle. The recovery time for this kind of fracture would be a lot dependent on the kind of the fracture, the age and functionality of the person, and other vital details. The condition of the bones would also be another factor on the fracture healing time of the individual and even to the kind of nonsurgical or surgical procedure that he has to go through.

These are just of things that we need to know about tibial plafond fracture. We can now differentiate this form of ankle fracture from bimalleolar fracture and trimalleolar fracture.

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