Clinical efficacy and safety of limited internal fixation combined with external fixation for Pilon fracture: A systematic review and meta-analysis

Zhang, Shaobo; Zhang, Yibao; Wang, Shenghong; Zhang, Hua; Liu, Peng; Zhang, Wei; Ma, Jun; Wang, Jing

doi:10.1016/j.cjtee.2016.06.012

Cited by 18 publications

(12 citation statements)

References 21 publications

(42 reference statements)

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“…To obtain ideal clinical outcomes, surgery should be planned to achieve anatomic reduction and stable fixation of the articular surface, tibial alignment restoration, minimal damage to skin tissue, and preserved blood circulation [3]. Various methods for Pilon fracture treatment have been reported, such as minimally invasive plate osteosynthesis (MIPO) [4], external fixation [5], open reduction and internal fixation (ORIF) [6], and intramedullary interlocking nails [7]. However, when these classical strategies are adopted to treat high-force Pilon fracture with associated soft tissue damage, it is difficult to obtain the optimal result.…”

Section: Introductionmentioning

confidence: 99%

Novel anterior curved incision combined with MIPO for Pilon fracture treatment

Peng

Ren

et al. 2020

BMC Musculoskelet Disord

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Backgrounds: Poor prognosis was reported for complex Pilon fractures involving severe soft tissue damage. It is therefore useful to explore the evolution of different treatment strategies in an effort to reconstruct the axial alignment and articular surface, while minimizing additional damage to the surrounding soft tissues. Methods: Seventeen patients with Pilon fractures were enrolled in this retrospective study from December 2009 to October 2014. The injuries were graded according to AO Classification and the Gustilo-Anderson system. Patients were treated with minimally invasive plate osteosynthesis (MIPO) combined with curved incision on the anterior area of ankle. The ankle function and radiological outcome were assessed by the modified Mazur ankle score and Burwell-Charnley criteria, respectively. Visual analogue score (VAS) score was used to assess the degree of patient's ankle pain, and related complications were also recorded. Results: The mean time for fracture healing was 3.6 months (range: 3-6 months). According to Mazur's criteria, surgical treatment achieved good or excellent outcome in 15 (88.2%) cases, and the average VAS score was 1.19 ± 0.52. On the basis of Burwell-Charnley score, 12 (70.5%) patients achieved anatomic recovery, 4 (23.5%) obtained good reduction, and only 1 (5.9%) patient was diagnosed with valgus deformity. Additionally, 1 (5.9%) patient developed a superficial infection around incision, and 2 (11.8%) experienced superficial peroneal nerve damage. In addition, 2 (11.8%) patients showed radiographic evidence of existing ankle osteoarthritis at the final follow-up. Conclusions: This retrospective study is the first to assess the application of a curved incision on the anterior area of ankle with MIPO for the treatment of Pilon fractures, which achieves high functional recovery with a low complication rate. However, large randomized controlled trials comparing different approaches and fixation methods are still needed to conclusively identify the optimal treatment protocol.

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Section: Introductionmentioning

confidence: 99%

Novel anterior curved incision combined with MIPO for Pilon fracture treatment

Peng

Ren

et al. 2020

BMC Musculoskelet Disord

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“…The management of these fractures present numerous challenges to the orthopaedic surgeon, particularly for the Rüedi-Allgöwer III or AO type C3 pilon fracture which represents severely comminuted fractures with impaction of the distal tibia. [4] Various methods for the pilon fracture reconstruction have been reported, including minimally invasive plate osteosynthesis (MIPO), [5] external xation, [6] open reduction and internal xation (ORIF), [7] and intramedullary interlocking nails. [8] For cases combined with a risk of soft tissue and osseous sepsis, reconstructive techniques included early xation, upgrading, primary arthrodesis, staged sequential posterior and anterior xation, acute shortening, and trans-syndesmotic bular plating.…”

Section: Introductionmentioning

confidence: 99%

Large Autologous Ilium with Periosteum for Tibiotalar Joint Reconstruction in Rüedi-Allgöwer III Pilon Fractures

Liu

Zhu

et al. 2020

Preprint

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Background: Management of Rüedi-Allgöwer III or AO type C3 pilon fracture present numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients with soft tissue injury of Tscherne-Gotzen I-II after Rüedi-Allgöwer III pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis.Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36).Conclusions: Large autologous ilium with periosteum in combination with ORIF can be safely performed for tibiotalar joint reconstruction. This method greatly reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III pilon fractures.Level of Evidence: Level III, retrospective cohort study

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“…Various methods for the pilon fracture reconstruction have been reported, including minimally invasive plate osteosynthesis (MIPO) [6], external xation [7], open reduction and internal xation (ORIF) [8], and intramedullary interlocking nails [9]. For cases combined with a risk of soft tissue and osseous sepsis, reconstructive techniques included early xation, upgrading, primary arthrodesis, staged sequential posterior and anterior xation, acute shortening, and trans-syndesmotic bular plating [10].…”

Section: Introductionmentioning

confidence: 99%

Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures

Liu

Zhu

et al. 2020

Preprint

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Background: Management of Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture presents numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients according to Tscherne/Oestern FxCO-I closed fracture and FxOI open fractures classification after Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis. Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36). Conclusions: Large autologous ilium with periosteum in combination with ORIF can be performed for tibiotalar joint reconstruction. This procedure reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures in short follow-up.Level of Evidence: Level III, retrospective cohort study

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Clinical efficacy and safety of limited internal fixation combined with external fixation for Pilon fracture: A systematic review and meta-analysis

Cited by 18 publications

References 21 publications

Novel anterior curved incision combined with MIPO for Pilon fracture treatment

Novel anterior curved incision combined with MIPO for Pilon fracture treatment

Large Autologous Ilium with Periosteum for Tibiotalar Joint Reconstruction in Rüedi-Allgöwer III Pilon Fractures

Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures

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