Fractures of the tibial pilon. Long-term functional results

Fernández-Hernández, Ó.; Álvarez-Posadas, I.; Betegón-Nicolás, J.; González-Fernández, J.J.; Sánchez-Herraéz, S.

doi:10.1016/s1988-8856(08)70087-7

Cited by 2 publications

(3 citation statements)

References 24 publications

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“…In line with other comparable studies [ 1 , 15 ], the most common technique used in our cohort was ORIF, which was performed more frequently in both type B (73.53%) and C fractures (58.33%) ( p < 0.05). As the use of the definitive external fixation procedure or the two-stage procedure protocol, in combination with ORIF, represents the gold standard of treatment of pilon fractures in cases of associated soft tissue lesions [ 17 – 27 ], the choice between the one- and two-stage procedure standard protocol in our case series was made in the majority of cases on the basis of the state of the soft tissues ( p < 0.05) according to our institutional protocol and in a few cases on the basis of the preferences and experience of the surgeons involved in the operations. Further, the choice of using the Procallus Fixator or the Hybrid Fixator for definitive treatment (one-stage procedure) instead of the circular frame was mainly made for biomechanical reasons.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the high incidence of complications with poor outcomes reported in pilon fracture management [ 19 , 26 , 27 , 30 , 31 ], several authors [ 19 , 27 , 30 ] have tried to make their surgical approaches less invasive to limit damage of soft tissues. In our cohort, 39 patients (41.49%) showed early and/or late complications, rates comparable to those described in the literature [ 27 , 31 ]. However, 22 cases (23.40%) experienced early minor complications, including superficial infections, pin-track infections, or wound dehiscence, which were effectively treated by periodic medication, sometimes in association with oral antibiotic therapy for a few days.…”

Section: Discussionmentioning

confidence: 99%

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Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

Biz

Angelini

Zamperetti

et al. 2018

BioMed Research International

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Introduction The goal of this retrospective, observational, case series study was to evaluate the medium-long-term clinical and radiographic results of the three most common surgical osteosynthesis techniques used for the treatment of articular tibial pilon fractures: ORIF, MIPO, and EF. Materials and Methods A consecutive series of patients with articular pilon fractures who underwent surgery at our institution were enrolled in this study. Fractures were classified according to the Müller AO classification system. Overall outcomes took the following into account: radiographic quality of reduction, evaluated using Ovadia and Beals' criteria; clinical assessment, evaluated using the AOFAS questionnaire; and general health, evaluated with the SF36-v2 Health Survey. Results A total of 94 articular pilon fractures (34 type 43-B and 60 43-C) were evaluated with a mean follow-up of 56.34 months (range 33–101). The techniques used were ORIF, MIPO, and EF in 63 (67%), 17 (18.9%), and 14 cases (14.1%), respectively. According to Ovadia and Beals' criteria, good, fair, and poor results were reported in 61 (64.89%), 26 (27.66%), and 7 (7.45%) cases, respectively. The mean AOFAS score was 82.41 for MIPO, 79.83 for ORIF, and 50.57 for EF, respectively. Thirty-nine patients (41.49%) presented early and/or late complications. Conclusion Satisfactory outcomes using the three different techniques were reported. In particular, the radiographic outcomes were inversely proportional to the fracture comminutions and statistically different between internal and external osteosynthesis, but comparable between ORIF and MIPO techniques. On the other hand, the clinical outcomes were closely related to the soft tissue conditions and the anatomical reconstruction of the joint.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

Biz

Angelini

Zamperetti

et al. 2018

BioMed Research International

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“…3 Typically, remarkable comminution and impaction of the joint surface is associated with these high-energy traumas. [4][5][6] A case series of primary ankle arthrodesis using a retrograde calcaneal nail to treat closed comminuted tibial pilon fractures is presented. Clinical and radiologic outcomes as well as complications were analyzed.…”

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confidence: 99%

Primary Ankle Arthrodesis for Severely Comminuted Tibial Pilon Fractures

Al-Ashhab¹

2017

Orthopedics

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Management of severely comminuted, complete articular tibial pilon fractures (Rüedi and Allgöwer type III) remains a challenge, with few treatment options providing good clinical outcomes. Twenty patients with severely comminuted tibial pilon fractures underwent primary ankle arthrodesis with a retrograde calcaneal nail and autogenous fibular bone graft. The fusion rate was 100% and the varus malunion rate was 10%. Fracture union occurred at a mean of 16 weeks (range, 13-18 weeks) postoperatively. Primary ankle arthrodesis is a successful method for treating highly comminuted tibial pilon fractures, having a low complication rate and a high satisfaction score. [Orthopedics. 2017; 40(2):e378-e381.].

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Fractures of the tibial pilon. Long-term functional results

Cited by 2 publications

References 24 publications

Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

Primary Ankle Arthrodesis for Severely Comminuted Tibial Pilon Fractures

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