Stabilization of the fractured tibial plafond

Historically, open treatment of tibial plafond fractures has produced an unacceptable complication rate. The use of modern fracture treatment principles, such as indirect reduction and biological fixation, along with careful timing of surgery and handling of surrounding soft tissues, can minimize the complications for which these fractures are so well known. The surgical goals include restoration of extremity length and alignment, precise articular reconstruction, rigid fracture fixation, and early joint motion. Such goals are typically accomplished through formal open reduction with internal fixation or by limited internal fixation of the articular surface combined with an external fixation device. This article focuses on the operative management of distal tibial articular fractures with emphasis on avoiding potential complications.