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Fracturile pilonului tibial

Fracturile pilonului tibial. Conf. Dr. M. Nicolescu. Frecventa, Etiologie. 14% din fracturile gleznei accidente de schi accidente de circulatie caderi de la inaltime. Clasificare anatomica (Gay&Evrard 1962). marginale ant/post bimarginale supramaleolare sagitale.

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Fracturile pilonului tibial

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  1. Fracturile pilonului tibial Conf. Dr. M. Nicolescu

  2. Frecventa, Etiologie • 14% din fracturile gleznei • accidente de schi • accidente de circulatie • caderi de la inaltime

  3. Clasificare anatomica(Gay&Evrard 1962) • marginale ant/post • bimarginale • supramaleolare • sagitale

  4. Clasificare patogenica • compresie • pronatie-dorsoflexie • adductie-torsiune

  5. Tip I : fracturi intraraticulare, fara deplasare semnificativa Tip II : fracturi cu incongruenta articulara importanta Tip III : fracturi prin compresie cu importanta incongruenta articulara si metafizara I II III Clasificare(Ruedi&Allgower1969)

  6. Diagnostic • Clinic : inventar leziuni complicatii locale imediate : vasculo-nervoase teren patologic • Imagistic : radiografii centrate pe interliniu F + P radiografie gamba + picior radiografie dupa reducere incidente particulare sectiuni tomo/tomodensitometrice

  7. TratamentObiectiv : refacerea articulare • Osteosinteza : brose/suruburi/placa • Fixator extern + OS minima • Artrodeza d’emblee • Tractiune continua • Amputatie

  8. Complicatii secundare • Cutanate • Septice • Deplasare secundara • Sindrom algodistrofic • Calus vicios • Pseudartroza

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