Outcomes After Treatment of High-Energy Tibial Plafond Fractures

Pollak, Andrew N.; McCarthy, Melissa L.; Bess, R. Shay; Agel, Julie; Swiontkowski, Marc F.

doi:10.2106/00004623-200310000-00005

Cited by 246 publications

(180 citation statements)

References 36 publications

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“…For the external fixation group, no two-staged protocol was undertaken in this study and external fixation was always a definitive device. Similar to many other authors, we found that definitive external fixation provided more malunion, stiffness or pain than ORIF [6,8,10]. Thus, we believe that external fixation should be preferentially used in two-staged protocols as a temporary device before ORIF or limited internal fixation [1,5].…”

Section: Discussionsupporting

confidence: 86%

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Distal tibia fractures: management and complications of 101 cases

Joveniaux

Ohl

Harisboure

et al. 2009

International Orthopaedics (SICOT)

146

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Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12-46). Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. The average functional score was 76 points (range, 30-100 points), and complications occurred in 30 patients. Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol. For other cases, we recommend ORIF with early mobilisation.

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Section: Discussionsupporting

confidence: 86%

“…All of these techniques have advantages and disadvantages and there is no consensus concerning the management of these fractures [2,10].…”

Section: Introductionmentioning

confidence: 99%

Distal tibia fractures: management and complications of 101 cases

Joveniaux

Ohl

Harisboure

et al. 2009

International Orthopaedics (SICOT)

146

View full text Add to dashboard Cite

show abstract

“…This may be partially explained by the high-energy nature required to produce a comminuted injury. 29 Other surgical factors, such as possible increased time for surgical reconstruction of increasingly complex osseous and soft tissue injury may contribute. The statistically significant difference in the average number of days from injury to ORIF, 20.9 ± 15.5 days in the infected versus 13.6 ± 12.7 days in the non-infected (p ¼ .01), represents the proper treatment allocation and adequate decision making process of orthopaedic surgeons with the more severe injuries requiring a higher time interval for surrounding soft tissue optimization.…”

Section: Discussionmentioning

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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“…Treatment of these fractures, both operative and non-operative, can have high complication rates, reportedly between 27% and 54% [5,13,14,2,27]; high rates of revision surgery, reportedly from 10% to 23% [5,10,12]; and significant residual dysfunction [1,12,18]. Some of these problems are almost certainly related to damage to the overlying articular cartilage, which inevitably sustains additional injuries during the initial event.…”

Section: Discussionmentioning

confidence: 99%