Fractures of the Distal Tibial Metaphysis with Intra-articular Extension—The Distal Tibial Explosion Fracture

Kellam, James F; Jp, Waddell

doi:10.1097/00005373-197908000-00007

Cited by 168 publications

(67 citation statements)

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“…However, none of these patients had reached a stage that required an ankle arthrodesis. A review of literature reveals that studies reporting results of ORIF for pilon fractures quote a salvage arthrodesis rate of 0-26% [2,3,10,20]. We feel that our use of internal fixation allowed accurate reconstruction of the articular surface thus reducing the incidence of joint problems.…”

Section: Resultsmentioning

confidence: 96%

“…In a series of 56 patients, Babis et al [1] had the most favourable results with regard to ankle range of motion in patients treated with ORIF and mobilised early. In previously published studies, a variety of outcome measures to assess functional outcome have been used, which often were not validated [2,4,10,14,17,18]. In this study a validated, self-administered questionnaire of general health to focus specifically on the patient's perspective of their health status after surgery was used rather than a complex variety of different clinical parameters.…”

Section: Resultsmentioning

confidence: 99%

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Early internal fixation and soft tissue cover of severe open tibial pilon fractures

Conroy

Agarwal

Giannoudis

et al. 2003

International Orthopaedics

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We studied 32 consecutive patients with open distal tibial pilon fractures. All patients had radical debridement with immediate skeletal stabilisation and early soft-tissue cover with a vascularized muscle flap. The minimum follow-up was 1 (range 1-8) year. There were four superficial infections, two deep infections and two amputations. There were no long-term problems with union and no patient required an ankle fusion. Patients were assessed using the SF-36 questionnaire. There were significant differences from the US norm in physical function score (p<0.01), role physical score (p<0.05) and physical component score (p<0.01). Physical component score of 38.5 was significantly better (p<0.01) when compared with amputees from severe lower-extremity trauma. Our protocol for management resulted in a good functional outcome with low infection and amputation rates.Résumé Nous avons étudié 32 malades consécutifs avec une fracture ouverte du pilon tibial. Tous les malades avaient un débridement radical avec stabilisation squelettique immédiate et couverture tissulaire précoce avec un lambeau musculaire vascularisé. Le minimum de suivi était une année (1à 8 années). Il y avait 4 infections superficielles, 2 infections profondes et 2 amputations. Il n'y avait pas de problèmes de consolidation à long terme et aucune arthrodèse de cheville ne fut nécessaire. Les malades ont été étudiés à partir du questionnaire SF-36. Il y avait des différences significatives selon la norme américaine du score de la fonction physique (p<0.01), le rôle du score physique (p<0.05) et le score de la composante physique (p<0.01). Le score composant physique de 38.5 était considérablement meilleur (p<0.01) comparé aux amputés pour traumatisme distal sévére. Notre protocole de gestion de ces fractures a conduit à un bon résultat fonctionnel avec un taux d'infection et d'amputation très bas.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Early internal fixation and soft tissue cover of severe open tibial pilon fractures

Conroy

Agarwal

Giannoudis

et al. 2003

International Orthopaedics

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“…In former studies it was stated that Type I and Type II fractures as per the Rüedi-Allgöwer classification displayed better results than Type III fractures [22,24]. In this study, it was found that when compared in terms of the types of fracture, the functional results of type I and type II fractures are significantly better than type III fractures.…”

Section: Discussionmentioning

confidence: 52%

Factors affecting the results of tibial pilon fractures treated with open reduction internal fixation

Baser¹,

Arslan²,

Utkan³

et al. 2018

Med-Science

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The purpose of this study is to evaluate the short and medium term functional results of tibial pilon fractures treated in our clinic with the open reduction and internal fixation method and to investigate the factors affecting such results. 41 patients who were treated in our clinic between 1995 and 2009 with open reduction and internal fixation were included in this study. Looking at the postoperative radiographs, quality of reduction was evaluated as per the criteria of Ovadia and Beals. Functional results of the patients were assessed in line with the criteria of Teeny and Wiss. With the evaluation of postoperative radiographs, 17 (41.5%) excellent and good, 21 (51.2%) fair and 3 (7.3%) poor results were obtained. Functionally speaking, 26 patients (63.5%) displayed excellent and good, 8 displayed (19.5%) fair and 7 displayed (17%) poor results. It was found out that age, sex, the time spent before the operation, the period of immobilization following the operation and the presence of an accompanying fracture did not have a significant impact on the functional results. It was revealed that the type of fracture affects functional results. A positive correlation was found between the quality of reduction and the functional results. In the light of the findings of this study, it was concluded that in tibial pilon fractures treated with the internal fixation method, the type of fracture and the quality of reduction are important in identifying the short and medium term prognosis.

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“…[14], tip I ve tip II kırıklarda, cerrahi tedavi ile %80 başarı yakaladıklarını ancak, tip III kırıklarda bu oranın %44'lere düştüğünü bildirdiler. Kelam ve Waddell [16], çoğu rotasyonel kuvvetlere bağlı gelişmiş olan Pilon kırıklarında %94 iyi ve mükemmel sonuç bildirirken, yüksek enerjili travmalara bağlı kırıklarda bu oranın %53'lere düştüğünü ifade etmişlerdir. Bu araştırmacılar rijit internal fiksasyonu takiben erken dönemde başlanan eklem hareketlerinin tedavinin başarısını arttırmada en önemli etken olduğunu bildirdiler.…”

Section: Discussionunclassified

Tibia pilon kırıklarının cerrahi tedavi sonuçları

Üner¹,

Öztürk²,

Kılınç³

et al. 2013

CMJ

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Amaç. Bu çalışmada amacımız, cerrahi ile tedavi edilen tibia pilon kırıklarının orta dönem klinik ve radyolojik sonuçlarını incelemektir. Yöntem. Cumhuriyet Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Kliniği'nde Eylül 2004-Eylül 2011 yılları arasında cerrahi olarak tedavi edilmiş 43 Pilon kırıklı hastadan, son kontrolleri yapılan 25 hastanın 26 Pilon kırığı bu çalışmaya dahil edildi. Bulgular. Olguların 7'si kadın, 18'si erkekti. Olgularımızın yaş ortalaması 47,4 (Aralık 20-74). Olguların 8' i açık kırıktı (2'si tip 1, 2'si tip 2, 4'ü tip 3). Ruedi-Allgöwer sınıflamasına göre 13 hastada tip 1, 8 hasta tip 2 ve 5 hastada tip 3 kırık saptandı. Etiyolojide yüksekten düşme ilk sırayı almaktadır. On dokuz olguda aynı zamanda fibula kırığı vardı. Yirmi altı Pilon kırığının; 17'sine tek seanslı cerrahi girişim uygulandı. Yirmi altı Pilon kırığının 9'una birden fazla sayıda cerrahi girişim (7 olguya; 2 cerrahi girişim, 2 olguya; 3 cerrahi girişim) uygulandı. İki olguda kompartman sendromu tanısı ile fasiotomi açıldı. İki olguda cilt nekrozu gelişmesi nedeniyle yüzeyel cilt greftlemesi uygulandı. Üç olguda yara yeri enfeksiyonu gelişmesi nedeniyle implant çıkarımı uygulandı. Beş olguya allogreft (Deminarelize Bone Matrix ve cancellos chips) uygulandı. Sekiz olguda Sudeck artrofisi gelişti, 7 olguda osteoartrit gözlendi. Değerlendirmeler de AOFAS kriterleri kullanıldı. Yirmi altı Pilon kırığının 15'inde AOFAS skoru 70 ve üzeri çıktı. On olguda AOFAS skoru 50-70 arası çıktı. İki olguda AOFAS skoru 30-50 arası çıktı. Sonuç. Pilon kırıkların da başarılı sonuç alabilmek için çok iyi preoperatif planlama yapılmalıdır. Pilon kırıklarının tümü için geçerli tek bir başarılı tedavi yöntemi yoktur. Her kırığın ayrı olarak değerlendirilmesi, tedavinin iyi planlanarak cerrahi ilkelere uyulması gereklidir.Anahtar sözcükler: Tibia, pilon kırığı, içten tesbit, artroz Abstract Aim. In this study our aim was to evaluate medium term results of tibial pilon fractures clinically and radiologicaly that treated with surgical. Method. From September 2004 to September 2011, 43 patients were surgically treated for pilon fracture, after the final checks of 25 patiensts 26 pilon fracture evaluated for this study in Cumhuriyet University, Department of Orthopedics and Traumatology. Results. Seven of the cases were women and 18 men. Mean age was 47.4 years (20-74). Eight of the cases were open (2 type I, 2 type II and 4 type III). There were 13 type 1, 8 type 2, and 5 type 3 fractures according to Ruedi-Allgöwer respectively. Falling from the height take the first place in etiology. At the same time 19 fibula fracture observed. 26 out of 17 pilon fracture patients were treated by one-stage operations. 26 out of 9 Pilon fracture were treated by multiple operations (for 7 cases; 2 operation, for; 2 cases 3 operations). In 2 cases fasciotomy was operated with compartment diagnosis. In 2 cases due to developing skin necrosis superficial skin grafting were treated. In 3 cases due to the development of wound infection removal implant were treated....

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Fractures of the Distal Tibial Metaphysis with Intra-articular Extension—The Distal Tibial Explosion Fracture

Cited by 168 publications

References 0 publications

Early internal fixation and soft tissue cover of severe open tibial pilon fractures

Early internal fixation and soft tissue cover of severe open tibial pilon fractures

Factors affecting the results of tibial pilon fractures treated with open reduction internal fixation

Tibia pilon kırıklarının cerrahi tedavi sonuçları

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