Outcome of complex tibial pilon fractures definitively treated with external fixator

Abstract

<p class="abstract"><strong>Background:</strong> Complex tibial pilon fractures are typically sustained with high-energy mechanisms and they are often associated with severe soft tissue compromise that can frequently results in severe complications. The purpose of this prospective case series was to evaluate the radiological and clinical outcomes after the use of external fixation combined with minimally invasive osteosynthesis, as primary and definitive treatment of complex tibial pilon fractures.</p><p class="abstract"><strong>Methods:</strong> A prospective study was undertaken during the period from March 2012 to June 2016. A total number of 109 patients with complex tibial pilon fractures were managed in our institution and included in the study. All the patients were treated with external fixation and minimally invasive osteosynthesis. The mean follow-up period was 47 months (31-60 months). Clinico-radiological progression of fracture union as well as the functional outcome were studied.<strong></strong></p><p class="abstract"><strong>Results:</strong> Eighty fractures resulted from traffic accidents and type 43-C3 fracture according to AO/OTA classification was the most common. Seventy-eight were open fractures and 94 patients had associated distal fibular fractures. All patients were treated with monolateral external fixators for definitive management. The average time to union was 14 weeks (range 9-19). Eleven patients (10%) suffered superficial pin tract infection. One patient developed septic arthritis and evidence of radiological osteoarthritis was present in ten cases (9%) at final follow-up. The American orthopaedic foot and ankle society (AOFAS) score was 84.4±8.1, translating to good clinical results.</p><p class="abstract"><strong>Conclusions:</strong> This review concludes that external fixation, combined with minimally invasive osteosynthesis, consistently produces good functional results without serious complications.</p>

Fracture union in extra articular distal tibia fracture after definitive delta frame external fixation in COVID 19 pandemic: a case report

“…2 Management of distal tibia fractures is challenging, with various modalities of management like conservative casting, external fixation, intramedullary nailing, open reduction with plating and minimally invasive plate osteosynthesis. 3 Non-operative conservative treatment by slabs and casts decrease quality of life of patient due to prolonged immobilization of the limb with stiffness of knee and ankle joints. 1 Introduction of external fixators has brought about a revolutionary breakthrough in management of such difficult fractures which have poor soft tissue healing.…”