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Background
- Fracture of the distal end of the tibia aka tibial plafond (French for ceiling) after the talar dome is driven into it
- Typically due to high energy axial loading injuries (motor vehicle accident, fall from height)
- Also known as a tibial plafond fracture
- Fairly common; account for 5-10% of all tibial fractures
- Average age of occurrence is 35-45 years old; males > females
Clinical Features
- Ankle pain/deformity
- Inability to bear weight
- Local tenderness to palpation
Differential Diagnosis
Evaluation
Work-Up
- Plain radiographs
- AP, Lateral, and Mortise views of ankle
- CT often necessary to reveal amount of articular surface displacement/develop treatment plan
Diagnosis
- Assess distal pulse, motor, and sensation
- Inspect skin for signs of open fracture
- Suspect other fracture as well, given mechanism:
- Lumbar spine (esp L1), calcaneus, talar dome, tibial plateau, femoral neck, acetabulum,
- Monitor for compartment syndrome
Management
Specific Management
Disposition
- If stabilized without evidence of significant articular displacement, can be managed as outpatient after consultation with Ortho
Admit for
See Also
References