Medial Tibial Plafond Involvement in Pilon Fractures
The provided evidence does not contain specific percentage data regarding medial tibial plafond involvement in pilon fractures. However, based on the available literature, I can provide relevant anatomical and clinical context about fracture patterns.
Fracture Pattern Distribution
The medial column of the distal tibia is commonly involved in pilon fractures, though exact percentages are not specified in the current evidence. 1
Key Anatomical Considerations
Pilon fractures typically involve multiple articular fragments including anterior, posterior (Volkmann), and medial components, with the specific pattern depending on the mechanism and energy of injury 1
Medial column fractures frequently occur in association with fibular fractures in complex pilon injury patterns 1
The fracture configuration varies based on impact energy and direction, with high-energy compression forces from the talus into the distal tibia creating variable patterns of articular involvement 2, 3
Clinical Relevance for Surgical Planning
CT imaging is essential for characterizing the extent of medial plafond involvement, as it demonstrates 100% sensitivity compared to 83% for radiographs in detecting tibial plateau fractures 4
Surgical approach selection depends on fragment location: medial tibial approaches are specifically indicated when anterior/anterolateral or posterior fragments involve >25% of the articular surface 1
The anteromedial approach, while providing access to medial fragments, carries higher rates of skin necrosis and posttraumatic ankle osteoarthritis compared to anterolateral approaches 5
Important Caveats
The absence of specific percentage data in the literature reflects the highly variable nature of pilon fracture patterns. Each fracture requires individualized CT assessment to determine the precise extent of medial plafond involvement for surgical planning 1, 6.