Anterolateral distal tibia locking plate osteosynthesis and their ability to capture OTAC3 pilon fragments

Aneja, Arun; Luo, T. David; Liu, Boshen; Molina, Domingo; Danelson, Kerry A.; Halvorson, Jason J.; Carroll, Eben A.

doi:10.1016/j.injury.2017.12.015

Cited by 25 publications

(18 citation statements)

References 11 publications

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“…In a secondary surgical intervention, the focus is on anatomical reduction of the articular surface, which should be performed in the posterior to anterior direction [65,66]. In a recent study, it was shown that anterolateral plating may not be sufficient in stabilizing the medial malleolar fragment [67]. To achieve sufficient stability, supplementation with an additional medial plate is recommended [65,68].…”

Section: Ankle Fracturesmentioning

confidence: 99%

Biomechanics of Osteoporotic Fracture Fixation

Hollensteiner

Sandriesser

Bliven

et al. 2019

Curr Osteoporos Rep

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Purpose of Review Fractures of osteoporotic bone in elderly individuals need special attention. This manuscript reviews the current strategies to provide sufficient fracture fixation stability with a particular focus on fractures that frequently occur in elderly individuals with osteoporosis and require full load-bearing capacity, i.e., pelvis, hip, ankle, and peri-implant fractures. Recent Findings Elderly individuals benefit immensely from immediate mobilization after fracture and thus require stable fracture fixation that allows immediate post-operative weight-bearing. However, osteoporotic bone has decreased holding capacity for metallic implants and is thus associated with a considerable fracture fixation failure rate both short term and long term. Modern implant technologies with dedicated modifications provide sufficient mechanical stability to allow immediate weight-bearing for elderly individuals. Depending on fracture location and fracture severity, various options are available to reinforce or augment standard fracture fixation systems. Summary Correct application of the basic principles of fracture fixation and the use of modern implant technologies enables mechanically stable fracture fixation that allows early weight-bearing and results in timely fracture healing even in patients with osteoporosis.

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Section: Ankle Fracturesmentioning

confidence: 99%

Biomechanics of Osteoporotic Fracture Fixation

Hollensteiner

Sandriesser

Bliven

et al. 2019

Curr Osteoporos Rep

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“…The choice of surgical approach for pilon fractures is closely related to the type of fracture. [ 13 ] In a study using CT scans to describe fracture lines in 38 patients, Cole found that the main compressed area in 36 pilon fractures was located at the central portion of the anterolateral column. [ 18 ] By analyzing imaging data of 126 patients with fractures, Topless found that high energy injuries were predominantly valgus type, and that 56% of patients had fracture lines in the coronal plane, with the medial column having mostly simple fractures.…”

Section: Discussionmentioning

confidence: 99%

“…It is believed that the plate could maintain the joint surface reduction and minimize loss of reduction more effectively, and it is also conducive to allowing early activity. [ 13 ] After the fractures of the tibia and fibula were fixed, we removed the femoral retractor and examined the stability of the fracture fixation and tibiofibular joint with a Cotton test to determine the need for syndesmotic screws. The skin was closed with interrupted 3-0 nylon sutures (Fig.…”

Section: Methodsmentioning

confidence: 99%

Treatment of the tibial pilon fractures using the antero-medial fibula approach

Ren

Wang²,

Liu³

et al. 2020

Medicine

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Pilon fractures are always results of the high-energy trauma. They are often accompanied with serious soft tissue injury, and tension blisters happened in most cases. For comminuted fractures and poor soft tissue, how to select the incision is challenging. This study aimed to explore the outcomes of the treatment of ten 43-B/C pilon fractures using an anteromedial fibula approach. Ten closed pilon fractures combined with fibula fractures were treated in our hospital from January 2015 to July 2016. Six cases were AO/OTA type 43-B and 4 cases were 43-C, including 9 males and 1 female with a mean age of 36.3 years (range: 20–60 years). When the skin wrinkled, all patients were treated by the senior authors with open reduction and internal fixation using an anteromedial fibula approach. Postoperatively, patients were followed up at 1 month, 3 months, 6 months, 12 months, and 18 months, respectively. The incision healing, the American Orthopedic Foot and Ankle Society scores and fracture healing were recorded to get a comprehensive evaluation of the effect for the incision. All patients were followed from 9 to 18 months (average: 14.1 months). Anatomic reduction was achieved in 7 cases and satisfactory in 3 cases by the Burwell–Charnley radiological criteria evaluation. All patients had complete retention of the dorsal extensor tendon sheath. The most incisions had a good healing without necrosis at 2 weeks after surgery except 1 case. The factures were healed at a range of 12 to 18 weeks (average: 13.7 ± 1.2 weeks). The American Orthopedic Foot and Ankle Society scores were excellent in 7 cases and good in 3 cases at 1 year after surgery (average: 85.6 ± 4.2 points). The satisfactory outcomes were achieved in most patients. The anteromedial fibula approach used for pilon fractures can lead to an effective exposure and allow fixation of tibia and fibula fractures with minimal soft tissue injury. It is a safe, simple, and effective approach that allows for satisfactory functional rehabilitation of the ankle joint. Level of evidence: therapeutic Level IV.

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“…The evaluation was performed and validated by experienced orthopaedic surgeons. The fragment was considered to be purchased if it was intersected with at least three complete threads of one screw and was deemed to be "captured" if it was purchased by at least two screws (21)(22)(23), thereby controlling rotational forces on each fragment. The VA screw was used only if the fragment could not be purchased by a monoaxial screw.…”

Section: Evaluate Fixation Effectivenessmentioning

confidence: 99%

Ability of modern proximal tibial lateral plates to capture posterolateral tibial plateau fracture fragments

Yan¹,

Zhan²,

Xie³

et al. 2022

Ann Transl Med

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Background: The surgical treatment of posterolateral tibial plateau fractures involves a challenging and diverse set of considerations, one of which is the lack of proper and satisfactory internal fixations to purchase posterolateral fragments. Evaluating the configuration of internal fixations is often overlooked, despite it being important to outcomes of fracture fixation. This study aimed to (I) propose a new digital methodology of internal fixation evaluation that based on actual fracture cases and (II) evaluate the fixation effectiveness of four commercially available proximal tibial lateral plate-screw constructs for posterolateral fragments.Methods: Tibial plateau fractures involving the posterolateral column were retrospectively reviewed. The reconstructed three-dimensional (3D) fracture models were virtually reduced, and targeted internal fixations were modeled digitally in specialized software. Four implants from three manufacturers (DePuy Synthes,

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Anterolateral distal tibia locking plate osteosynthesis and their ability to capture OTAC3 pilon fragments

Cited by 25 publications

References 11 publications

Biomechanics of Osteoporotic Fracture Fixation

Biomechanics of Osteoporotic Fracture Fixation

Treatment of the tibial pilon fractures using the antero-medial fibula approach

Ability of modern proximal tibial lateral plates to capture posterolateral tibial plateau fracture fragments

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