Fractures of the Tibial Pilon

Bartlett, Craig S.; Putnam, Ryan M.; Endres, Nathan K.

doi:10.1016/b978-1-4160-2220-6.10059-3

Cited by 11 publications

(7 citation statements)

References 134 publications

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“…9,[11][12][13] Early ORIF was reported to have up to a 55% deep infection rate, 6% rate of osteomyelitis, and overall 54% incidence of complications requiring further surgery. 9,[11][12][13] Owing to the high rate of complications with early ORIF, definitive external fixation treatment of these injuries was proposed. [14][15][16][17][18][19][20][21][22] These studies reported lower rates of soft tissue complications at the expense of greater articular incongruity as reduction was largely obtained through ligamentotaxis.…”

Section: Discussion and Historical Comparisonmentioning

confidence: 99%

“…Treatment methods of pilon fractures include casting, traction, internal fixation, external fixation, and combinations of both internal and external fixation. 9,11 Historical treatment methods utilized early ORIF and had an unacceptably high rate of soft tissue complications and infections. 9,[11][12][13] Early ORIF was reported to have up to a 55% deep infection rate, 6% rate of osteomyelitis, and overall 54% incidence of complications requiring further surgery.…”

Section: Discussion and Historical Comparisonmentioning

confidence: 99%

“…9,11 Historical treatment methods utilized early ORIF and had an unacceptably high rate of soft tissue complications and infections. 9,[11][12][13] Early ORIF was reported to have up to a 55% deep infection rate, 6% rate of osteomyelitis, and overall 54% incidence of complications requiring further surgery. 9,[11][12][13] Owing to the high rate of complications with early ORIF, definitive external fixation treatment of these injuries was proposed.…”

Section: Discussion and Historical Comparisonmentioning

confidence: 99%

See 2 more Smart Citations

Primary Blade Plate Arthrodesis for Unreconstructable Distal Tibia Fractures

Kiner

Johnson

Nowotarski

2013

Techniques in Foot &Amp; Ankle Surgery

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Section: Discussion and Historical Comparisonmentioning

confidence: 99%

Section: Discussion and Historical Comparisonmentioning

confidence: 99%

Section: Discussion and Historical Comparisonmentioning

confidence: 99%

See 1 more Smart Citation

Primary Blade Plate Arthrodesis for Unreconstructable Distal Tibia Fractures

Kiner

Johnson

Nowotarski

2013

Techniques in Foot &Amp; Ankle Surgery

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“…Pilon fractures account for 5% to 7% of distal tibial fractures. [ 1 ] It is caused by an axially-directed compressive force on the tibia, and the number of fracture fragments is directly related to the rotational force imparted, with 75% to 85% having an associated fibular fracture. [ 2 ] As distal tibial soft tissue coverage is thin, pilon fractures are often associated with serious soft tissue injury, and the tension blisters is observed in most cases.…”

Section: Introductionmentioning

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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“…Although a wide variety of approaches have been suggested, 2,8,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] we will concentrate on those that offer the best access for each particular fracture. The coronal plane deformity as a result of the fracture provides clues regarding areas of tension and compression failure.…”

Section: Introductionmentioning

confidence: 99%

Strategies for Surgical Approaches in Open Reduction Internal Fixation of Pilon Fractures

Assal

Ray

Stern

2015

Journal of Orthopaedic Trauma

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Pilon or tibial plafond fractures usually result from high-energy injuries with rotation and/or axial compression. They occur in an area of relatively poor soft tissue coverage and frequently present a surgical challenge in deciding which incisions will be best for performing open reduction internal fixation. A variety of anterior and posterior approaches have been described based on the ease of fracture reduction and internal fixation with plates. Some of the incisions are fracture specific, that is, planned for a limited approach to the pilon. But in more complex cases, a wider exposure is indicated and thus more extensile approaches, both anterior and posterior, can be valuable. This review article will describe the different surgical approaches, focusing on their indication and technique.

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Fractures of the Tibial Pilon

Cited by 11 publications

References 134 publications

Primary Blade Plate Arthrodesis for Unreconstructable Distal Tibia Fractures

Primary Blade Plate Arthrodesis for Unreconstructable Distal Tibia Fractures

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

Strategies for Surgical Approaches in Open Reduction Internal Fixation of Pilon Fractures

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