the most severe damage to the ankle and up 7% of all skeletal injuries 4. Results: Ankle previously regarded as a cylindrical helical hinge. Bending foot, as it were come unscrewed from the plug with simultaneous ankle supination her, and bringing a small rotation inside. When straightening foot, on the contrary, as if the plug is screwed into the joint, at the same time it is pronation, abduction and slight external rotation. It is known that the ankle is shaped like a truncated cone with the base directed toward the fibula. The imaginary axis of the cone is rotated by about 10 degrees relative to the proximal articular surface of the talus, and 25 degrees relative to the frontal plane. (Source: Ali Partovi). For practice, it is important that the imaginary axis of the ankle goes from the lower edge of the inner ankle to the lower edge of the outer ankle 1. Pylons fractures called fractures of the distal tibia metaepiphysis arising from the effects of axial forces of high-energy, which leads to position of the foot during the injury, the direction and magnitude of traumatic force.
Also, damage to the ankle depends on the direction of traumatic force which may be of 3 types: adduction, abduction, rotation. During supination external Ligamental structures are strained. With a gap of enhanced external adduction ligament tear or fracture podsindesmozny outer ankle, and the talus clicks the inner ankle, resulting in a fracture occurs and the vertical plane. If supinate stop the load is rotated outward, in addition to the external voltage lateral ligaments stretched anterior ligament syndesmosis. If the force continues its impact, then there is an oblique or spiral fracture nadsindesmozny chrezsindesmozny or outer ankle. Rotating astragalus may pull back a bunch of syndesmosis, breaking it, or removing a bone fragment posterior margin of the tibia.
Its destructive effect of the rotating talus fracture completes the inner ankle or torn deltoid ligament. When pronatsionnom position of the foot stretched internal structures. If there is a rigid abduction, can be torn deltoid ligament tear or inner ankle (with the horizontal fracture). Then continuing Violence breaks both syndesmosis ligament tears or bone fragments in them. Then the autopsy results in a fracture of the fibula at or above the syndesmosis. If at the initial position of the foot she pronatsionnom rotated laterally, there is a gap deltoid ligament or transverse fracture of the inner ankle. With the continuing rotation of the outer talus anterior ligament rupture occurs tibiofibular syndesmosis or separation of the bone attachment 2, 3. Conclusions: The mechanism of the pylon fractures depends on the direction of the damaging efforts and position of the foot at the time of injury. References 1. Oganesyan OV, Ivannikov SV, Korshunov AV Recovery form and function of the ankle joint hinge-distraction apparatus. – Moscow: BINOM. Laboratory knowledge. – Medicine. – 2003. – S. 12-13 2. Shabanov AN, Kay I., Sartan VA Atlas fractures ankle and their treatment. – M.: Medicine. – 1972. – S. 44-67. 3. Kao KF, Huang PJ, Chen YC, et al. Postero-medial-anterior approach of the ankle for the pilon fracture / / Injury. – 2000. – Vol. 31. – P. 71-74. 4. Topliss CJ, Jackson M., Atkins RM: Anatomy of pilon fractures of the distal tibia / / JBJS. – 2005. – Vol. 87 – P.692-697. Tekt article is copyrighted