Tibial pilon fractures are rare injuries most often associated with soft tissue injuries, occurring during high-energy trauma. Surgical treatment represents the therapy of choice and must ensure anatomical reconstruction of the joint surface while respecting the surrounding tissues.
The evolution of our results showed a majority of good functional clinical radio results by the open treatment which showed its superiority compared to the closed treatment and the combined treatment. Tibial Pestle , Osteosynthesis , Surgery. The study of tibial pilon fractures deserves particular interest because they can jeopardize the functional prognosis of the ankle.
Type C represents an articular depression fracture, with frequent epiphyseal comminution according to the classification of Ruedi and Heim AO, They occur during high-energy trauma AVP, fall from a high place, and so on. These are serious fractures given their complexities, their therapeutic difficulties and the absence of muscular coverage with poor vascularization making the prognosis severe and dominated by the risk of skin necrosis, infection, malunion, pseudarthrosis or even osteoarthritis [2].
Fractures of the distal end of the tibia result from high-energy trauma by axial compression. They are located in an anatomical region whose tissue envelope is thin and particularly exposed. Surgical treatment must ensure bone reduction as precise as possible while respecting the surrounding tissues. The osteosynthesis must be stable to allow early mobilization. Operative planning is an essential moment in treatment and is carried out through rigorous clinical observation and exact radiological interpretation of the characteristics of the fracture.
The metaphysoepiphyseal complexity of these lesions requires CT imaging with multiplanar reconstruction. The development of anatomical implants with angular stability and the recent improvement in the definition of surgical approaches have clearly changed the prognosis of these lesions. Recognition of the importance of the free surgical interval before definitive osteosynthesis is the principle that has certainly secured their care the most.
