Foot Loading and Gait Analysis Evaluation of Nonarticular Tibial Pilon Fracture: A Comparison of Three Surgical Techniques

Falzarano, Gabriele; Pica, Giuseppe; Medici, Antonio; Rollo, Giuseppe; Bisaccia, Michele; Cioffi, R. P.; Pavone, Mario; Meccariello, Luigi

doi:10.1053/j.jfas.2018.03.025

Cited by 40 publications

(34 citation statements)

References 24 publications

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“…Falzarano et al reported no significant difference in the anatomical axis of the non-articular tibial fracture between the hybrid external, plate and screw, and intramedullary nailing fixation groups [25].…”

Section: Discussionmentioning

confidence: 96%

Effectiveness of circular external fixator in periprosthetic fractures around the knee

Nozaka

Miyakoshi

Hongo

et al. 2020

Preprint

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Background: The incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. The usefulness of circular external fixation for periprosthetic fractures has been reported in several case studies. The aim of this study was to investigate the rate of union and complications associated with circular external fixation in periprosthetic fractures around the knee. Methods: We included 19 patients with periprosthetic femur and tibial fractures who underwent osteosynthesis using a circular external fixator and had at least 2 years of follow-up. All patients had comorbidities and high risks associated with anesthesia. Tourniquets were not used in any of the patients. There were no cases in which the skin incision was placed, and the closed reduction technique was used in all cases. Results: A 100% union rate was achieved with no serious complications. All fractures healed after a mean time of 14.3±5.2 weeks (range, 8-38 weeks). The walking ability was the same level as before the injury in 13 cases. Discussion: There are many comorbidities associated with periprosthetic fractures in elderly patients. Double-plate or revision surgery were largely invasive and had high risks associated with anesthesia. Circular external fixation is a feasible and effective treatment option because it provides stable fixation, prompt postoperative mobilization, and has no major complications, especially in elderly patients who are treated for periprosthetic fractures Conclusion: Circular external fixation is a safe and reliable method for periprosthetic fractures around the knee in elderly patients. Level of evidence: Level IV, retrospective case series

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Section: Discussionmentioning

confidence: 96%

Effectiveness of circular external fixator in periprosthetic fractures around the knee

Nozaka

Miyakoshi

Hongo

et al. 2020

Preprint

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“…Expanding this concept to the proximal tibia and tibia plateau fractures would be interesting, investigating if there are any differences between the types of fixation and gait pattern outcomes for the patients with tibia plateau fractures. 44 …”

Section: Discussionmentioning

confidence: 99%

Physiotherapy after tibial plateau fracture fixation: A systematic review of the literature

Iliopoulos¹,

Galanis

2020

SAGE Open Medicine

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Background: Tibial plateau fractures are frequent injuries that orthopaedic surgeons face. It has been reported that they have a significant negative impact on the patients’ lives, decreasing their quality of live, keeping them of work for long periods of time and reducing their activity levels. Aim: Interestingly, there is not enough focus in the literature about the post-operative rehabilitation of these patients. The aim of the present review is to investigate this field of the literature and try to give answers in four main questions: the range of motion exercises post-surgery, the immobilisation, the weight-bearing status and the ongoing rehabilitation. Materials and Methods: A literature search was conducted using the PubMed and the Google Scholar search engines. A total of 39 articles met the criteria to be included in the study. Results: The literature about this subject is scarce and controversial. Early range of motion exercises should be encouraged as soon as possible after the procedure. The immobilisation after plate fixation does not seem to be correlated with any benefits to the patients. The weight-bearing status of the patients was the most controversial in the literature with the early weight-bearing gaining ground at the most recent studies. Tibia plateau fractures can have significant impact on the patients’ lives, so ongoing rehabilitation with focus on quadriceps strengthening and proprioception exercises is recommended. Conclusion: The present literature review illuminates the controversy that exists in the literature about the physiotherapy following tibia plateau fracture fixation. Early range of motion exercises and early weight bearing should be encouraged. Immobilisation does not seem to provide any benefit. Ongoing rehabilitation should be considered with the view of better clinical outcomes.

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“…The malunion of lower extremity fractures, failure of corrective osteotomies and genetic or metabolic bone disorders are recognized as the most frequent causes of alignment deviations [6]. The improvement of mechanical axis, proper mechanical load and stable fixation are the crucial factors to achieve operative success [7,8]. It is estimated that up to 12% of patients with extra- articular deformities can be affected by knee osteoarthritis that makes this problem common for orthopedic surgeons [9].…”

Section: Discussionmentioning

confidence: 99%

Total knee arthroplasty with simultaneous tibial shaft osteotomy in patient with multiple hereditary osteochondromas and multiaxial limb deformity – a case report

Grzelecki

Szneider

Marczak

et al. 2020

BMC Musculoskelet Disord

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Background: Hereditary multiple osteochondromas (hereditary multiple exostoses, HME) is a rare genetic disease characterized by the development of benign osteocartilaginous tumors that may cause severe limb deformities and early onset osteoarthritis. Total knee arthroplasty (TKA) is the method of choice for the treatment of advanced gonarthrosis, however the surgical management with coexisting severe axial limb deformity remains unclear. Case presentation: 65-year-old man with HME and extra-articular multi-axial limb deformity was admitted to the orthopedic department due to chronic knee pain and limited range of motion caused by secondary osteoarthritis. Regarding to the clinical and radiological examinations, after preoperative planning he was qualified to a one-stage TKA combined with tibial shaft osteotomy (TSO). In a one year follow-up full bone union was confirmed with no signs of implant loosening or prosthesis displacement. Patient was very satisfied, did not report any joint pain and has sufficient range of motion without knee instability. Conclusion: The improvement of mechanical axis during TKA is a crucial factor for achieve operative success and long implant survival. Despite the higher risk of complication rate in comparison to two-stage treatment, one-stage TKA with simultaneous TSO should be a considerable method for patients with osteoarthritis and multiaxial limb deformities. This method can give a good clinical and functional outcomes, however should be performed subsequently to careful preoperative planning and proper patient qualification.

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Foot Loading and Gait Analysis Evaluation of Nonarticular Tibial Pilon Fracture: A Comparison of Three Surgical Techniques

Cited by 40 publications

References 24 publications

Effectiveness of circular external fixator in periprosthetic fractures around the knee

Effectiveness of circular external fixator in periprosthetic fractures around the knee

Physiotherapy after tibial plateau fracture fixation: A systematic review of the literature

Total knee arthroplasty with simultaneous tibial shaft osteotomy in patient with multiple hereditary osteochondromas and multiaxial limb deformity – a case report

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