Patient reported health related quality of life early outcomes at 12 months after surgically managed tibial plafond fracture

Bonato, Luke; Edwards, Elton; Gosling, Cameron; Hau, Raphael; Hofstee, Dirk Jan; Shuen, Alex; Gabbe, Belinda

doi:10.1016/j.injury.2016.11.012

Cited by 26 publications

(14 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a similar study in Australia of a 12-month examination of pilon fractures, lower SF-12 PCS values were obtained. [8] A concomitant lateral malleolar fracture was observed to reduce the functional results in the current study (p=0.028). In a study by Liangjun et al, [27] higher functional results were obtained in pilon fractures with an intact lateral malleolus.…”

Section: Discussionmentioning

confidence: 50%

“…[7] Another problem encountered in these fractures is low quality of life due to inability to undertake daily tasks and a late return to work. [8,9] Although this study is short-term and presents different surgical techniques, it may be able to provide some ideas for these deficiencies. It is necessary to know the complications of pilon fractures affecting long-term foot functions and quality of life and the effects of these to be able to predict them and take precautions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Mid-term Effects on Quality of Life and Foot Functions following Pilon Fracture

Yaradılmış

Okkaoğlu

Kılıç

et al. 2020

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

BACKGROUND: Although pilon fractures are uncommon, they are of importance to orthopaedic surgeons because of the difficulty of treatment. Poor outcomes and high complication rates are seen despite various surgical methods. This study aims to examine the changes affecting the quality of life and foot functions in patients applied with open reduction and internal fixation (ORIF) for a pilon fracture. METHODS: In this study, a total of 45 patients treated with ORIF for a pilon fracture in our clinic between January 2010 and December 2016 were evaluated with AOFAS and SF-12 in a total of 10 categories according to demographic data, fracture classification and surgical technique. In addition to functional values, patient records were examined regarding complications, including infection, soft-tissue defect, malalignment, non-union, arthrosis and Sudeck atrophy. In patients with AOFAS <85 and low SF-12 scores, variables were examined and the relationship with complications was evaluated. RESULTS: The mean follow-up period was 3.7 years (range 2 to 7). The AOFAS value was determined to fall to <85 when the Ruedi Allgower classification increased (p=0.010), when AO classification increased (p=0.020), when there was a concomitant lateral malleolar fracture (p=0.028), and when the status was non-anatomic according to the Ovadia Bell criteria (p=0.031). The SF-12 PCS value was observed to decrease when the Ruedi Allgower classification increased (p=0.018) and when the status was non-anatomic according to the Ovadia Bell criteria (p=0.012). A correlation was determined between the SF-12 PCS and the AOFAS values (p=0.000). CONCLUSION: The reasons for the failure of ORIF in tibia pilon fractures were found to be Ruedi 3 classification, concomitant lateral malleolar fracture, and non-anatomic surgical reduction. Failure in foot functions has a direct effect on quality of life in both the short and mid term.

show abstract

Section: Discussionmentioning

confidence: 50%

Section: Introductionmentioning

confidence: 99%

The Mid-term Effects on Quality of Life and Foot Functions following Pilon Fracture

Yaradılmış

Okkaoğlu

Kılıç

et al. 2020

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

show abstract

“…Open tibial plafond fractures (Orthopaedic Trauma Association and AO Foundation [OTA/AO] 43) commonly result in poor outcomes. 6 Substantial risk of soft tissue complications, such as deep infection (closed fractures, 20%; open fractures, 30%), amputation (3%-14%), 1,23,24 and wound breakdown, are not uncommon. These fractures typically result from high-energy trauma.…”

Section: Introductionmentioning

confidence: 99%

Outcomes and Complications With Treatment of Open Tibial Plafond Fractures With Circular External Fixator

et al. 2021

View full text Add to dashboard Cite

Background: Open tibial plafond fractures (Orthopaedic Trauma Association and AO Foundation [OTA/AO] 43) are associated with severe complications, including deep infection (closed fractures, 20%; open fractures, 30%), amputation (3%-14%), and nonunion (up to 25%). Circular external fixators (CEFs) can minimize soft tissue injury. This study aimed to report the rate of union and occurrence of severe complications in patients with open tibial plafond fractures treated with CEFs. Methods: A retrospective review of case series was conducted at 3 level I trauma centers. The study included patients older than 18 years with open tibial plafond fractures treated with CEFs. The reported outcomes included union rate, deep infection, operative complications, and limb alignment. The radiographic measurements of anatomic alignment were obtained. Fifty-two patients were included in the study. Results: The primary union rate was 79%. No deep infection occurred in the majority (92%) of patients. No patient required amputation of the affected limb or free flap coverage. Conclusion: Definitive fixation of open tibial plafond fractures with CEFs avoided severe soft tissue complications but resulted in variation in final radiographic alignment. Level of Evidence: Level IV, case series.

show abstract

“…Значительно улучшились возможности визуализации переломов при помощи компьютерной томографии, что расширило диагностические возможности хирургов и облегчило процесс предоперационного планирования [6][7][8][9]. Двухэтапный протокол лечения с первичной наружной фиксацией, которая впоследствии заменяется на внутреннюю, стал общепринятым при лечении высокоэнергетических повреждений рассматриваемой локализации [10,11].…”

unclassified

“…Разработано множество предызогнутых имплантатов с угловой стабильностью и доступов для их имплантации, значительно расширяющих возможности хирурга [8,12]. Тем не менее лечение переломов пилона сопровождается большим количеством осложнений и неудовлетворительных результатов [11][12][13][14]. Их причинами являются как особенности анатомии сегмента, заключающиеся в малом объеме мягких тканей при наличии значительного количества клинически значимых сосудов и нервов, так и отсутствие единого взгляда на хирургическое лечение этих повреждений.…”

unclassified

Modern Views on Surgical Treatment of Pilon Fractures

Belenkiy¹,

Mayorov²,

Usenov³

2018

СПНО (MPSE)

View full text Add to dashboard Cite

В работе описаны традиционные классификации переломов пилона и новые варианты классификаций, основанные на данных компьютерной томографии и согласующиеся с применяемой при переломах других локализаций теорией колонн. Изложены также возможные механизмы получения этой травмы. Описаны данные современной литературы, посвященные различным подходам к хирургическому лечению этих повреждений и хирургическим доступам, говорящие о том, что консенсус в выборе оптимального метода лечения переломов пилона отсутствует. Общепризнанным в настоящее время является лишь двухэтапный протокол лечения данной группы пациентов. Из методов окончательной фиксации возможны открытая репозиция и внутренняя фиксация из расширенного доступа, малоинвазивный остеосинтез -как самостоятельный метод, так и в комбинации с аппаратом наружной фиксации, а также только аппарат наружной фиксации. При этом все методы имеют специфические преимущества и недостатки. Констатировано, что основной нерешенной проблемой хирургии переломов пилона является желание улучшить визуализацию суставного компонента перелома, что увеличивает травматичность операции, при необходимости минимизировать дополнительные повреждения мягких тканей области перелома. Решение может быть найдено в разработке концепции малоинвазивной внутренней фиксации переломов дистального отдела большеберцовой кости. Ключевые слова: перелом пилона, малоинвазивный остеосинтез, хирургические доступы. Traditional and new based on CT classifications of pilon fractures and possible mechanisms of these injuries were described. New classifications take into account columns theory as well as with fractures of other localizations. Different strategies of surgical treatment and different surgical approaches to distal tibial metaphysis were analyzed. Based on the analysis carried out, it is concluded that there is no consensus on the choosing a method of treatment in cases of pilon fractures. Currently, only a two-stage treatment protocol is generally accepted. Possible methods of definitive fixation of pilon fractures are following: open reduction internal fixation, minimally invasive plate osteosynthesis, combination of minimally invasive plate osteosynthesis with external fixator and only external fixation. All these techniques have specific advantages and disadvantages. It is stated that the main unresolved problem of pilon fractures surgery is the desire to improve the visualization of the articular component of the fracture that increases the traumatism and the need to minimize additional soft tissues damage during surgical procedure. A solution could be found in the development of the concept of minimally invasive internal fixation of such fractures.

show abstract

Patient reported health related quality of life early outcomes at 12 months after surgically managed tibial plafond fracture

Cited by 26 publications

References 20 publications

The Mid-term Effects on Quality of Life and Foot Functions following Pilon Fracture

The Mid-term Effects on Quality of Life and Foot Functions following Pilon Fracture

Outcomes and Complications With Treatment of Open Tibial Plafond Fractures With Circular External Fixator

Modern Views on Surgical Treatment of Pilon Fractures

Contact Info

Product

Resources

About