Treatment of high-energy pilon fractures using the ILIZAROV treatment

Osman, Walid; Alaya, Zeineb; Kaziz, Hamdi; Hassini, Lassaad; Braiki, Meriem; Naouar, Nader; Ml, Ben Ayeche

doi:10.11604/pamj.2017.27.199.11066

Cited by 18 publications

(33 citation statements)

References 15 publications

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“…In the present study, we used monolateral external fixator for complex tibial pilon fractures as definitive treatment, which allowed fracture union with functional mobility. The average time to union was of 14 weeks which was comparable to studies by Mitkovic et al and Osman et al 19,3 However other factors like open fracture at the time of injury, post-operative infections, smoking habits, and others, do affect the time to union.…”

Section: Discussionsupporting

confidence: 83%

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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Section: Discussionsupporting

confidence: 83%

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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“…However, the optimal solution has not been determined [40][41][42][43]. Previous research indicates 6 BioMed Research International that olive wires could also offer enough compression to maintain the fracture's stability [44][45][46]. The threaded part of the pin utilized for medial malleolus fixation in this study increased the friction to the bone, which composed a stronger fixation with the combination of compression offered by olive wire.…”

Section: Medial Malleolus Fixationmentioning

confidence: 88%

Effects and Anti-rotation Stabilization of the Non-bridging External Fixation for Pronation-Abduction Stage III Ankle Fracture: A Cadaveric Study

Chen

Huang

Cheng

et al. 2021

BioMed Research International

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Objective. This study is aimed at providing a nonbridging external fixation technique with pinning fixation for the pronation-abduction stage III ankle fracture. The secondary purpose was to evaluate its effect on anatomic reduction and fracture fragment stability against cadaveric models’ rotation. Method. A paired design study was conducted using 14 pairs of the cadaveric model which had been modeled for pronation-abduction stage III ankle fracture. One fracture model from each pair was randomly allocated to receive an open reduction and internal fixation, while the other was reduced and stabilized with the external fixation technique. After the surgery, the antirotational stability tests were performed with external rotation torques of 10 nm, 15 nm, and 20 nm applied, respectively. The postoperation reduction rate and ankle parameters were recorded in anteroposterior and lateral radiographs before and after the antirotational stability experiment. Result. The outcomes were assessed according to Burwell-Charnley’s radiographic criteria of reduction. It showed no statistically significant differences in reduction between the two groups ( P < 0.05 ). The displacement of lateral fragment following a reduction in the external fixation group was significantly larger than that of the internal fixation group ( 3.14 ± 0.56 vs. 1.49 ± 0.39 , P < 0.05 ). After applying rotational torques of 10 nm, 15 nm, and 20 nm, the results of other parameters showed no significant differences between the two groups. Conclusion. This nonbridging external fixation method with pin fixation of fracture fragments might have the same effect as that of internal fixation on the reduction rate of pronation-abduction stage III ankle fracture.

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“…Although there are few studies that have reported the joint reduction quality following surgery of highenergy pilon fractures, in a study of 30 patients treated with Ilizarov external fixator, Osman et al [17] reported that acceptable reduction was obtained in 46.6% and poor reduction in 20%. In another study of 17 patients, Kapoor et al [13] reported that in 4 patients with AO-43C3 type open tibial pilon fractures, acceptable joint reduction was obtained with Ilizarov external fixator passing the joint.…”

Section: Discussionmentioning

confidence: 99%

“…In 30 patients with high-energy tibialpilon fractures treated with Ilizarov external fixator by Osman et al [17], arthrosis developed in the joint in 11 patients, but no information was given about the grade of arthrosis. Fırat et al [23] compared the Ilizarov external fixator techniques of fixed to the ankle and jointed at the ankle in 34 patients operated on for tibial pilon fracture.…”

Section: Discussionmentioning

confidence: 99%

Open tibial pilon fractures: treatment with ankle-spanning Ilizarov fixator

Şahin¹,

Kalem²

2017

The European Research Journal

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Objectives. The aim of this retrospective study was to report the treatment results obtained with the anklespanning Ilizarov fixator technique in the treatment of complex OTA/AO type 43C3 open tibial pilon fractures. Methods. A total of 14 patients with open OTA/AO type 43C3 tibial pilon fractures were evaluated. The demographics and fracture characteristics, preoperative and postoperative radiological evaluations, duration of follow-up (months), time to union (months) and complications were recorded. After collection of operative data, patients were invited for functional and radiological outcome evaluation. American Orthopaedic Foot and Ankle Society (AOFAS) scores and range of movement (ROM) of the ankle joint were investigated. Also radiologically the ankle osteoarthritis level according to the Bargon et al. criteria was noted. Results. The mean age of the patients was 48.7 years (range, 26-72 years). The mean follow-up period was 32 months (range, 25-46 months). The clinical and radiological time to union was mean 6.5 months (range, 5-11 months). On the postoperative ankle CT images, the separation within the ankle was measured as < 2mm in all patients and in 3 patients, stepping was measured as > 2mm. Following removal of the external fixator, dorsiflexion was measured as mean 15.5° (range, 0°-23°) and plantar flexion as mean 26.14° (range, 13°-36°). The mean AOFAS was 80.35 (range, 56-92). Conclusion. Satisfactory results can be obtained with the Ilizarov external fixator passing the ankle in the permanent treatment of AO-43C3 type open tibial pilon fractures.

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Treatment of high-energy pilon fractures using the ILIZAROV treatment

Cited by 18 publications

References 15 publications

Outcome of complex tibial pilon fractures definitively treated with external fixator

Outcome of complex tibial pilon fractures definitively treated with external fixator

Effects and Anti-rotation Stabilization of the Non-bridging External Fixation for Pronation-Abduction Stage III Ankle Fracture: A Cadaveric Study

Open tibial pilon fractures: treatment with ankle-spanning Ilizarov fixator

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