Post-operative outcomes of open reduction and internal fixation versus circular external fixation in treatment of tibial plafond fractures: A systematic review and meta-analysis

Malik-Tabassum, Khalid; Pillai, Kavya; Hussain, Yusuf; Bleibleh, Sabri; Babu, Satish; Giannoudis, Peter V.; Tosounidis, Theodoros H.

doi:10.1016/j.injury.2020.04.056

Cited by 26 publications

(30 citation statements)

References 37 publications

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“…Interestingly, the recent meta-analysis by Malik-Tabassum et al found that deep infection rates were not significantly different between CEF and ORIF. They noted a significantly increased risk of superficial wound infection, attributed to simple pin-site infections, as echoed in this systematic review [ 46 ].…”

Section: Reviewmentioning

confidence: 73%

Post-Operative Outcomes of Circular External Fixation in the Definitive Treatment of Tibial Plafond Fractures: A Systematic Review

Legg¹,

Malik-Tabassum²,

Ibrahim³

et al. 2022

Cureus

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Tibial plafond fractures (TPFs) are uncommon but potentially devastating injuries to the ankle. Operative treatments include internal and external fixation modalities. This article provides a systematic review of the clinical and functional outcomes of TPFs treated specifically with circular external fixation (CEF). A literature search of medical databases from inception to 13th November 2020 was performed. Original studies written in the English language reporting clinical, radiological, and functional outcome data of TPF treated with CEF were included. Patient demographics, fracture classification, open fractures, post-operative complications, clinical outcomes, radiological outcomes, and functional outcomes were collected. Quality and risk of bias were assessed using standardised scoring tools.In total, 16 studies were included. One prospective randomised study was identified. Collated data of 303 patients were analysed. The mean time to union was 21 weeks. Malunion occurred in 12.4%. The rate of deep infection was 4.8%, but no amputations were recorded. The risk of minor soft tissue infection (including pin-site infections) was 54%. Almost two-thirds achieved good-to-anatomic reduction radiologically. Approximately one-third reported excellent functional outcome scores. The quality of the studies was deemed satisfactory. A moderate risk of bias was acknowledged. This systemic review provides a summary of outcome data regarding CEF as a treatment for TPF. It highlights CEF as an acceptable treatment option with comparable results to that of internal fixation. Further higher-quality evidence is advised.

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Section: Reviewmentioning

confidence: 73%

Post-Operative Outcomes of Circular External Fixation in the Definitive Treatment of Tibial Plafond Fractures: A Systematic Review

Legg¹,

Malik-Tabassum²,

Ibrahim³

et al. 2022

Cureus

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“…The management of colorectal cancer has progressed over the past few decades because of many advances, including those in genetics, pathology, imaging, medical oncology, radiation oncology, and surgery. 16 Undoubtedly, the management of patients afflicted with colorectal cancer will evolve as advances continue to be made in the multiple disciplines that contribute to the diagnosis and treatment of colorectal cancer.…”

Section: Resultsmentioning

confidence: 99%

“…15 Malik-Tabassum et al conducted a systematic review and meta-analysis comparing ORIF with external fixation. 16 The authors concluded that there was a preference in treating more severe injuries of tibial pilon with external fixation.…”

Section: Discussionmentioning

confidence: 99%

Outcome of complex tibial pilon fractures definitively treated with external fixator

Lemsanni¹,

Najeb²,

Chafik³

et al. 2020

Int J Res Orthop

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Background: 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.Methods: 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.Results: 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.Conclusions: This review concludes that external fixation, combined with minimally invasive osteosynthesis, consistently produces good functional results without serious complications.

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“…One of the established treatment methods for the type of distal tibia fractures called pilon fractures is Ilizarov fixation. This method is chosen particularly for extensive injuries involving soft tissue damage and compound fractures that result from considerable forces [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Kinematic Parameters Following Pilon Fracture Treatment with the Ilizarov Method

Wietecki

Pawik

Lwow

et al. 2022

JCM

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Background: The purpose of our study was to analyze kinematic parameters following pilon fracture treatment with the Ilizarov method. Methods: Our study assessed kinematic parameters of gait in 23 patients with pilon fractures treated with the Ilizarov method. Patients had completed their treatment 24–48 months prior to measurements. The range-of-motion values in the non-operated limb (NOL) and operated limb (OL) were compared. Kinematic parameters were measured using the Noraxon MyoMOTION System. Results: We observed no significant differences in hip flexion, hip abduction, or knee flection between the OLs and NOLs in patients after treatment with the Ilizarov method. We observed significant differences in the ranges of ankle dorsiflexion, inversion, and abduction (p < 0.001; p < 0.001; p < 0.003, respectively) between the OLs and the NOLs. Conclusion: Following pilon fracture treatment with the Ilizarov method, we observed no differences in terms of knee or hip joint mobility between the OL and the NOL, whereas the range of motion in the ankle joint of the OL was significantly limited. The treatment of pilon fractures with the Ilizarov method does not ensure the complete normalization of ankle joint kinematic parameters. Therefore, intense personalized rehabilitation of the ankle joint is recommended.

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Post-operative outcomes of open reduction and internal fixation versus circular external fixation in treatment of tibial plafond fractures: A systematic review and meta-analysis

Cited by 26 publications

References 37 publications

Post-Operative Outcomes of Circular External Fixation in the Definitive Treatment of Tibial Plafond Fractures: A Systematic Review

Post-Operative Outcomes of Circular External Fixation in the Definitive Treatment of Tibial Plafond Fractures: A Systematic Review

Outcome of complex tibial pilon fractures definitively treated with external fixator

Kinematic Parameters Following Pilon Fracture Treatment with the Ilizarov Method

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