Management of high-energy tibial pilon fractures

Jacob, Nebu C; Amin, Amit; Giotakis, Nikolaos; Narayan, Badri; Nayagam, Selvadurai; Trompeter, Alex

doi:10.1007/s11751-015-0231-5

Cited by 58 publications

(20 citation statements)

References 52 publications

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“…There are significant factors that complicate the treatment of such fractures. One of such factors is the insufficiency of soft tissue support and blood supply at the fracture area [3,6,11]. Another important factor is the fact that mostly such fractures occur as a result of high-energy traumas.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the surgical treatment took place in an average of 7 days [2][3][4][5][6][7][8][9][10][11][12][13][14][15] after admission to the hospital. Within this period all patients were under observation at the hospital with skeletal traction or cast splint fixation.…”

Section: Discussionmentioning

confidence: 99%

“…1-5% of all lower extremity fractures and 7-10% of all tibia fractures are tibial pilon fractures [1,2]. In addition to the difficulty faced in the anatomic reduction and the stable fixation of such fractures, the accompanying soft tissue damage increases the frequency of postoperative complications [3][4][5][6]. Identifying the timing of surgery and the surgical method to be applied in a manner that suits the case is important, particularly for high-energy fractures [3,4,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to the difficulty faced in the anatomic reduction and the stable fixation of such fractures, the accompanying soft tissue damage increases the frequency of postoperative complications [3][4][5][6]. Identifying the timing of surgery and the surgical method to be applied in a manner that suits the case is important, particularly for high-energy fractures [3,4,[6][7][8]. While anatomic reduction is of importance for intra-articular fractures, for pilon fractures whether the clinical results are related with to what extent the joint is anatomically restored is still debated [9].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Studies reporting on patient-reported outcome following complex fractures of the tibia support the persistence of limitations in QOL throughout time [3, 4, 15, 35]. However, most studies evaluating patient-reported outcomes do not use a reference population or pre-injury values.…”

Section: Discussionmentioning

confidence: 99%

Complex tibial fractures are associated with lower social classes and predict early exit from employment and worse patient-reported QOL: a prospective observational study of 46 complex tibial fractures treated with a ring fixator

Elsøe¹,

Larsen²,

Petruskevicius³

et al. 2017

Strategies in Trauma and Limb Reconstruction

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The long-term outcomes following complex fractures of the tibia are reported to carry a risk of knee pain, malalignment, articular injury and post-traumatic osteoarthritis. The main objective of this study was to account for the patient-reported quality of life (QOL) 12 months after ring fixator removal in patients with a complex tibial fracture. Secondary objectives included a review of the socio-economic characteristics of the patient group and the rate of return to work in the study period. A prospective follow-up study was conducted of 60 patients with complex fractures of the tibia treated with ring external fixation. Patient-reported outcomes, radiological outcomes and socio-economic status including employment status of the patients were obtained 12 months after frame removal. Forty-six patients completed the assessment 12 months after frame removal (77%). The mean age of the patient at the time of fracture was 54.6 years (range 31–86). There were 19 males and 27 females. At 12 months after frame removal, the mean EQ5D-5L index was 0.66 (CI 0.60–0.72). The mean EQ5D-5L VAS was 69 (CI 61–76). When this was compared to the established reference population from Denmark, the study population showed a significantly worse EQ5D-5L index. The majority of patients (87%) were in the lower social classes suggesting a higher degree of social deprivation in the study population. Twenty-seven per cent of patients who were employed prior to injury had returned to employment at approximately 19 months following fracture. The onset of post-traumatic osteoarthritis was present in the knee joint in 29% of patients following a proximal intra-articular fracture, whereas osteoarthritis was present at the ankle joint in 35% of patients following a distal intra-articular fracture 12 months after frame removal. This study indicates that at 12 months after frame removal there are poorer patient-reported QOL as when compared to reference populations. Furthermore, this study suggests that complex tibial fractures are associated with lower social classes and that only 27% of patients in this sample, who prior to injury were employed, had returned to employment at approximately 19 months after the injury.

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Epidemiology of Post-traumatic Osteoarthritis of the Lower Extremity: Premature Aging of Youthful Joints

Arant

Katz

2021

Early Osteoarthritis

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Management of high-energy tibial pilon fractures

Cited by 58 publications

References 52 publications

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

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

Complex tibial fractures are associated with lower social classes and predict early exit from employment and worse patient-reported QOL: a prospective observational study of 46 complex tibial fractures treated with a ring fixator

Epidemiology of Post-traumatic Osteoarthritis of the Lower Extremity: Premature Aging of Youthful Joints

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