Double plate osteosynthesis in a C1-C2 tibial pilon fracture: two case reports

Tibial pilon fractures, despite their infrequency, while accounting for 4-10% of all tibial fractures and less than 1% of all fractures of the lower extremity, still represent a challenge for orthopedic surgeons due to their poor prognosis. We present two case reports of C1-C2 tibial pilon fractures, through which we try to demonstrate that double plate fixation offers a superior stability to the osteosynthesis both in case of articular rim multi-fragmentarity, wherein primary key-fragments can be fixed by anatomically shaped plates, to better restore the articular surface and joint stability, and in the scenario of long spiroid or extended oblique fractures, whereby a buttressing and a supporting plate best domain the vertically directed shear forces that tend to diastase the three pilon columns.