Arthroscopically Assisted Reconstruction and Percutaneous Screw Fixation of a Pilon Tibial Malunion

Nehme, Alexandre; Tannous, Ziad; Wehbe, Joseph; Mecharrafieh, Ramzi; Maalouf, Ghassan

doi:10.1053/j.jfas.2007.08.010

Cited by 8 publications

(8 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We considered a healing time of less than 6 months as normal, between 6 and 9 months as a delayed union, and more than 9 months as nonunion [ 14 ]. Malunion was defined as more than 5 degrees of angular or rotational deformity [ 15 ]. Posttraumatic arthritis was described as painful range of motion with radiographic evidence of a narrowed joint space.…”

Section: Methodsmentioning

confidence: 99%

The Feasibility of 3D Printing Technology on the Treatment of Pilon Fracture and Its Effect on Doctor-Patient Communication

Zheng

Chen

Zhang

et al. 2018

BioMed Research International

View full text Add to dashboard Cite

Purpose The aim of this study was to assess the feasibility and effectiveness of the three-dimensional (3D) printing technology in the treatment of Pilon fractures. Methods 100 patients with Pilon fractures from March 2013 to December 2016 were enrolled in our study. They were divided randomly into 3D printing group (n = 50) and conventional group (n = 50). The 3D models were used to simulate the surgery and carry out the surgery according to plan in 3D printing group. Operation time, blood loss, fluoroscopy times, fracture union time, and fracture reduction as well as functional outcomes including VAS and AOFAS score and complications were recorded. To examine the feasibility of this approach, we invited surgeons and patients to complete questionnaires. Results 3D printing group showed significantly shorter operation time, less blood loss volume and fluoroscopy times, higher rate of anatomic reduction and rate of excellent and good outcome than conventional group (P < 0.001, P < 0.001, P < 0.001, P = 0.040, and P = 0.029, resp.). However, no significant difference was observed in complications between the two groups (P = 0.510). Furthermore, the questionnaire suggested that both surgeons and patients got high scores of overall satisfaction with the use of 3D printing models. Conclusion Our study indicated that the use of 3D printing technology to treat Pilon fractures in clinical practice is feasible.

show abstract

Section: Methodsmentioning

confidence: 99%

The Feasibility of 3D Printing Technology on the Treatment of Pilon Fracture and Its Effect on Doctor-Patient Communication

Zheng

Chen

Zhang

et al. 2018

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Nehme et al described one case of distal tibia pilon malunion that was treated arthroscopically. The patient initially had 6 weeks of treatment via external fixator but had diastasis and step off at the medial malleolus [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of malunion after tibia fracture treatment after casting and functional bracing has been 0 to 68% [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] and as high as 20% after intramedullary nailing in distal tibial fractures [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is a consensus on what is considered a radiographic malunion of the tibia, but it is still debated what the criteria should be to correct a malunited tibia in an asymptomatic patient, especially if many patients with deformity are reported to be asymptomatic in the long term. It seems like any deformity that falls below the values stipulated by our parameters (5–10 degrees angulation, 1–2 cm shortening, 10–15 degrees IR and 10–20 degrees ER) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ] is tolerated and deformity around our parameters may be tolerated but more severe deformities are likely not well-tolerated and should be corrected [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Malunion of the Tibia: A Systematic Review

et al. 2022

View full text Add to dashboard Cite

Background and Objectives: Tibial malunions are defined as tibial fractures that have healed in a clinically unacceptable position, resulting in deformity such as shortening, lengthening, abnormal rotation, or angulation. These deformities can have adverse effects on patients, such as pain and gait disturbance, as well as long term development of post-traumatic arthritis. This paper seeks to highlight some of the options for surgical management of malunions and detail the strategies and approaches used to manage these complicated cases. Materials and Methods: An exhaustive search was conducted on PubMed using the key search terms “Tibial” OR “Tibia” AND “Malunion” to be included in the title. Exclusions to the search included any article with patients aged < 18 years, any nonhuman subjects, and any article not published or translated into English. Results: A systematic review of the literature revealed 26 articles encompassing 242 patients who had undergone surgical correction for tibia malunion. A total of 19 patients suffered from complications. Methods of treatment included osteotomies, with plate and screws, external fixator, angled blade plate, intramedullary nails, Ilizarov fixator, Taylor Spatial Frame, Precise nail, and total knee arthroplasty. Restoring alignment and the articular surface led to overwhelmingly positive patient outcomes. Conclusions: Tibial malunions take many forms, and as such, there are many approaches to correcting deformities. The literature supports the following radiological parameters to diagnose tibial malunion: 5–10 degrees angulation, 1–2 cm shortening, 10–15 degrees internal rotation, and 10–20 degrees external rotation. Surgical plans should be customized to each individual patient, as there are many approaches to tibial malunion that have been shown to be successful in delivering excellent clinical outcomes.

show abstract

“…4-8 Although the role of arthroscopy is expanding, its use in the setting of acute trauma, with the exception of the knee, is mostly undefined. 9,10 There are numerous reports of arthroscopic-assisted treatment of acute foot and ankle trauma, 11-24 but there is no universal agreement with regard to specific indications in this arena.…”

Section: Introductionmentioning

confidence: 99%