Operative Treatment of Fractures of the Tibial Plafond. A Randomized, Prospective Study*

Wyrsch, Brad; Mcferran, Mark A.; McAndrew, Mark P.; Limbird, Thomas J.; Harper, Marion C.; Johnson, Kenneth D.; Schwartz, Herbert S.

doi:10.2106/00004623-199611000-00003

Cited by 342 publications

(244 citation statements)

References 24 publications

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“…This reflects the notion that fracture of the malleoli is the most severe risk factor for development of ankle OA [40]. Tibial plafond fractures, the second most frequent fracture type in our study, are known to be associated with a high rate of posttraumatic OA [4,42]. This is believed to be caused by a combination of articular damage, avascular necrosis of fracture fragments, and/or difficulty in obtaining a satisfactory and accurate reduction [40].…”

Section: Discussionsupporting

confidence: 81%

“…However, the influence of an anatomic reduction on the prevalence of posttraumatic OA is questionable. One study showed a positive correlation between reduction and functional outcome [32], whereas others have disclaimed this correlation [4,42]. Although there is broad advocacy that the best fracture outcome is associated with minimal articular damage, anatomic reduction, early mobilization, and a lack of complications [22,40], more basic and clinical research is needed to understand the development of posttraumatic OA after fractures and to identify optimal methods to prevent it.…”

Section: Discussionmentioning

confidence: 99%

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Etiology of Ankle Osteoarthritis

Valderrábano

Horisberger

Russell³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

661

415

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The purpose of this study was to evaluate the distribution rate of etiologies leading to ankle arthritis and to quantify and compare the important clinical and radiologic variables among these etiologic groups. We evaluated data from 390 patients (406 ankles) who consulted our center because of painful end-stage ankle osteoarthritis (OA) by using medical history, physical examination, and radiography. Posttraumatic ankle OA was seen in 78% of the cases (n = 318), secondary arthritis in 13% (n = 52), and primary OA in 9% (n = 36). The average American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was 38 points (range, 0-74 points), range of motion was 22°(range, 0°-65°), and visual analog scale for pain was 6.8 (range, 2-10). Patients with posttraumatic endstage ankle OA were younger than patients with primary OA. The average tibiotalar alignment was 88°(range, 51°-116°) and did not differ between the etiologic groups. Our study showed trauma is the main cause of ankle OA and primary OA is rare. In the majority of patients with ankle OA the average tibiotalar alignment is varus regardless of the underlying etiology.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Etiology of Ankle Osteoarthritis

Valderrábano

Horisberger

Russell³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

661

415

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“…7e10 Even when treated according to modern standard of care, complications of infection and wound dehiscence occur and can result in considerable morbidity for patients. 11,12 Although several studies have reported deep infection rates, the general applicability is limited due to small sample size, and, no single study has evaluated for potential identifiable risk factors specific to the development of deep infection.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of deep infection in operatively treated pilon fractures (AO/OTA: 43)

Molina¹,

Stinner²,

Fras³

et al. 2015

Journal of Orthopaedics

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“…10 Wyrsch et al reported a 37% (7/19) risk of infection with three of those patients ultimately receiving a below-knee amputation, resulting in an amputation rate of 16% (3/19). 13 Guidelines for treatment of these complications have not been established, and currently there exists wide variation in management. Measuring success associated with treatments for these complications is difficult, in part because large series of this patient population have not been studied.…”

Section: Introductionmentioning

confidence: 99%