Management of distal tibial intra-articular fractures with circular external fixation

Lovisetti, Giovanni; Agus, Maria Alice; Pace, Fabrizio; Capitani, Dario; Sala, Francesco

doi:10.1007/s11751-009-0050-7

Cited by 33 publications

(18 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies were carried out to compare intramedullary nailing to plating, plating to external fixation and intramedullary nailing to external fixation. 18,19 Various clinical studies have compared IMN and MIPO 20,21,22 the former leads to a lower rate of soft tissue complications and infections and has been associated with a significantly shorter full weight bearing and a shorter union time. On the other hand, IMN appears has been reported to lead to a higher rate of malunion and nonunion because it may involve reduction issues 23,24 The present study was conducted to evaluate the functional outcome of distal tibia extra articular fracture operated with IMN and MIPO.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Distal Tibia Fractures Treated with Intramedullary Nailing versus Plating by MIPPO

Shingati¹,

Ratnam²,

Suresh³

2019

jebmh

View full text Add to dashboard Cite

BACKGROUND Tibia is the major weight bearing bone of the leg. It is the most commonly fractured long bone in the body with an annual incidence of Tibial shaft Fractures is two per 1000 individuals. Tibial fractures can cause a long morbidity and extensive disability unless treatment is appropriate. We wanted to assess extraarticular distal tibial fractures and compare the two surgical modalities of treatment i.e.; intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPPO). We also wanted to compare the clinical, radiological and functional outcome of these modalities of treatment. METHODS This is a prospective study conducted among 40 patients in the age group of 20-70 yrs., of both sexes taken up for intramedullary nailing/ MIPPO at Rajarajeswari Medical College and Hospital, Bangalore. Age group ranged from 22 to 62 years with majority of patients having RTA (77.5%). Duration of hospital stay in majority was about 10 days and IMN for 7 days. Union time in weeks for MIPPO group was about 20 weeks and in Intra Medullary Nailing group was about 18 weeks. Both intramedullary nailing and plating by MIPPO are the optimal methods of treatment in extra articular distal tibia fractures with no significant differences between union and complication rates. MIPPO is usually preferred in fractures which are within the AO muller square whereas IMN is preferred in fractures which are above it. RESULTS In MIPPO group, mode of injury was RTA in 70% and self-fall in 30% and in Intra Medullary Nailing group, mode of injury was RTA in 85% and self-fall in 15%. There was no significant difference in mode of injury between the two groups. In MIPPO group, 5% had Gustilo Anderson Grade 1 and in Intra Medullary Nailing group 10% had Gustilo Anderson Grade 1. There was no significant difference in Gustilo Anderson Grade 1 between the two groups. CONCLUSIONS Both intramedullary nailing and plating by MIPPO are the optimal methods of treatment in extraarticular distal tibia fractures with no significant difference between union and complication rates. MIPPO is usually preferred in fractures which are within the AO muller square whereas IMN is preferred in fractures which are above it.

show abstract

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Distal Tibia Fractures Treated with Intramedullary Nailing versus Plating by MIPPO

Shingati¹,

Ratnam²,

Suresh³

2019

jebmh

View full text Add to dashboard Cite

show abstract

“…Various clinical studies have compared IMN and LP [ 13 , 20 – 22 ]: the former leads to a lower rate of soft tissue complications and infections and has been associated with a significantly shorter full weight bearing and a shorter union time. On the other hand, IMN appears has been reported to lead to a higher rate of malunion and nonunion because it may involve reduction issues [ 16 , 19 , 20 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Nail or plate in the management of distal extra-articular tibial fracture, what is better? Valutation of outcomes

Bisaccia

Cappiello

Meccariello

et al. 2018

SICOT-J

View full text Add to dashboard Cite

Introduction: Distal tibial fractures are the most common long bone fractures. Several studies focusing on the methods of treatment of displaced distal tibial fractures have been published. To date, locked plates, intramedullary nails and external fixation are the three most used techniques. The aim of our study was to compare intramedullary nail (IMN) and locked plate (LP) for treatment of this kind of fracture.Materials and methods: We collected data on 81 patients with distal tibial fractures (distance from the joint between 40 and 100 mm) and we divided into two groups: IMN and LP. We compared in the 2 groups the mean operation time, the mean union time, the infection rate the rate of malunion and nonunion, the full weight bearing time.Results: No patient in the two groups developed a nonunion. None of the patients obtained a fair or poor outcome. Overall 52 patients obtained an excellent result (69.3%) and 23 obtained a good result (30.6%).Discussion: Our study results indicate a superiority of IMN over LP in terms of lower rates of infections and statistically significant shorter time to full weight bearing. Whereas LP appeared to be advantageous over IMN in terms of leading to a better anatomical and fixed reductions of the fracture and a lower rate of union complications. The two treatments achieved comparable results in terms of operation time, hospital stay, union time and functional outcomes.

show abstract

“…This is particularly important as some authors showed that circular frames are associated with less bony or soft tissue complications compared to ORIF for type C pilon fractures. 8 – 11 …”

Section: Discussionmentioning

confidence: 99%

Ipsilateral Pilon and Calcaneus Fractures: Treatment with Circular Frame without Spanning Ankle Joint

Dimitroulias

Harbacheuski

2011

Strategies in Trauma and Limb Reconstruction

View full text Add to dashboard Cite

This case report describes the treatment of a 48-year-old female patient, smoker, with a closed comminuted pilon fracture (AO/OTA 43-C2.1) and ipsilateral displaced intra-articular calcaneus fracture (AO/OTA 82-C3). Two independent circular frames were applied in a way to preserve tibiotalar range of motion (ROM). The posterior facet of the calcaneus fracture was reduced through a small incision anterior to the tip of the distal fibula. A frame consisting of a two-third ring was applied to the talus and a footplate to the calcaneus was used to hold the reduction of the posterior facet and to correct varus and length. Pilon fracture was similarly reduced with a percutaneous reduction technique and stabilized with the standard two Taylor spatial frame (TSF) rings. During the course of treatment, the tibiotalar joint ROM was maintained. The frame for the calcaneus fracture was removed 10 weeks after the surgery and the frame for the pilon fracture was removed 16 weeks after the surgery. The patient’s last follow-up was 34 months after the injury. She was ambulating independently without limp and she had resumed the preinjury activity level. She had symmetric tibiotalar ROM and 50% reduction in subtalar ROM. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot score was 76. Radiographs revealed healed pilon and calcaneus fractures, normal alignment of tibiotalar and subtalar joints, with some arthritic changes present to tibiotalar and subtalar joints. In conclusion, utilization of a “below the ankle” frame for the calcaneus fracture and a standard two-ring frame for the pilon fracture helps to avoid soft tissue complications and preserves tibiotalar ROM. How to cite this article Dimitroulias A, Harbacheuski R. Ipsilateral Pilon and Calcaneus Fractures: Treatment with Circular Frame without Spanning Ankle Joint. Strategies Trauma Limb Reconstr 2019;14(2):111–114.

show abstract

Management of distal tibial intra-articular fractures with circular external fixation

Cited by 33 publications

References 32 publications

A Comparative Study of Distal Tibia Fractures Treated with Intramedullary Nailing versus Plating by MIPPO

A Comparative Study of Distal Tibia Fractures Treated with Intramedullary Nailing versus Plating by MIPPO

Nail or plate in the management of distal extra-articular tibial fracture, what is better? Valutation of outcomes

Ipsilateral Pilon and Calcaneus Fractures: Treatment with Circular Frame without Spanning Ankle Joint

Contact Info

Product

Resources

About