scholarly journals Early internal fixation and soft tissue cover of severe open tibial pilon fractures

2003 ◽  
Vol 27 (6) ◽  
pp. 343-347 ◽  
Author(s):  
J. Conroy ◽  
M. Agarwal ◽  
P. V. Giannoudis ◽  
S. J. E. Matthews
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Tibial Pilon ◽  
Soft Tissue Cover ◽  
Pilon Fractures

scholarly journals Two-stage open reduction and internal fixation versus limited internal fixation combined with external fixation: a meta-analysis of postoperative complications in patients with severe Pilon fractures

2018 ◽  
Vol 46 (7) ◽  
pp. 2525-2536 ◽  
Author(s):  
Xueliang Cui ◽  
Hui Chen ◽  
Yunfeng Rui ◽  
Yang Niu ◽  
He Li
Keyword(s):  
Postoperative Complications ◽  
Internal Fixation ◽  
Bone Healing ◽  
Open Reduction ◽  
Lower Risk ◽  
Meta Analysis ◽  
Two Stage ◽  
Superficial Infection ◽  
Tibial Pilon ◽  
Pilon Fractures

Objectives Two-stage open reduction and internal fixation (ORIF) and limited internal fixation combined with external fixation (LIFEF) are two widely used methods to treat Pilon injury. However, which method is superior to the other remains controversial. This meta-analysis was performed to quantitatively compare two-stage ORIF and LIFEF and clarify which method is better with respect to postoperative complications in the treatment of tibial Pilon fractures. Methods We conducted a meta-analysis to quantitatively compare the postoperative complications between two-stage ORIF and LIFEF. Eight studies involving 360 fractures in 359 patients were included in the meta-analysis. Results The two-stage ORIF group had a significantly lower risk of superficial infection, nonunion, and bone healing problems than the LIFEF group. However, no significant differences in deep infection, delayed union, malunion, arthritis symptoms, or chronic osteomyelitis were found between the two groups. Conclusion Two-stage ORIF was associated with a lower risk of postoperative complications with respect to superficial infection, nonunion, and bone healing problems than LIFEF for tibial Pilon fractures. Level of evidence 2.

scholarly journals Open Reduction Internal Fixation versus External Fixation with Limited Internal Fixation for Displaced Comminuted Closed Pilon Fractures: A Randomised Prospective Study

2018 ◽  
Vol 24 (1) ◽  
pp. 84-89
Author(s):  
Rayan Ahmed ◽  
Kotb Ahmed ◽  
M. Elmoatasem Elhussein ◽  
Samir Shady ◽  
Tamer A. El-Sobky ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Prospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Articular Surface ◽  
High Energy ◽  
Complication Rates ◽  
Pilon Fractures

Background Pilon fractures involve the dome of the distal tibial articular surface. The optimal treatment for high-energy pilon fractures remains controversial. Some authors advocate the use of open reduction and internal fixation (ORIF) to avoid articular incongruence. Others advocate the use of bridging external fixation with limited internal fixation (EFLIF) to reduce soft tissue complications. Literature reports of prospective studies comparing the radioclinical outcomes of ORIF and EFLIF in high-energy fractures are scarce. Retrospective studies have their limitations because of insufficient randomisation. The objective of this randomised prospective study is to compare the clinical, radiologic and functional outcomes of displaced and comminuted closed pilon fractures, Rüedi and Allgöwer type II and III, treated by either ORIF or EFLIF. Materials and Methods Forty-two patients were selected for the study. Twenty-two patients were subjected to ORIF and 20 patients were subjected to EFLIF. We used the American Orthopaedic Foot and Ankle Society score as a standard method of reporting clinical status of the ankle. Patients were followed-up clinically and radiologically for over 2 years after the surgical treatment. Results The results of ORIF and EFLIF in treatment of high-energy pilon fractures are equally effective in terms of functional outcomes and complication rates on the short term. Conclusion Soft tissue integrity and fracture comminution seem to have a significant influence on outcomes of intervention. A prospective multicentre study with a larger sample size that controls for other associated variables and comorbidities is warranted. Level of evidence Level II.

scholarly journals Distal tibial pilon fractures (AO/OTA type B, and C) treated with the external skeletal and minimal internal fixation method

2013 ◽  
Vol 70 (9) ◽  
pp. 836-841 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Ivan Micic ◽  
Desimir Mladenovic ◽  
Stevo Najman ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Ankle Joint ◽  
Fixation Method ◽  
Universal Method ◽  
Type B ◽  
Tibial Pilon ◽  
Post Surgery ◽  
Articular Fractures ◽  
Type C ◽  
Pilon Fractures

Background/Aim. Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF) and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. Methods. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. Results. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60) years. The average follow-up was 21.86 (from 12 to 48) months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20) weeks. There were 4 (12.19%) infections around the pins of the external skeletal fixator and one (3.22%) deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90%) patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. Conclusion. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for treating all types of inta-articular pilon fractures. In fractures types B and C dynamic external skeletal fixation allows early mobility in the ankle joint.

The Results of Early Primary Open Reduction and Internal Fixation for Treatment of OTA 43.C-Type Tibial Pilon Fractures: A Cohort Study

2010 ◽  
Vol 24 (12) ◽  
pp. 757-763 ◽  
Author(s):  
Tim O White ◽  
Pierre Guy ◽  
Cameron J Cooke ◽  
Stephen A Kennedy ◽  
Kurt P Droll ◽  
...  
Keyword(s):  
Cohort Study ◽  
Internal Fixation ◽  
Open Reduction ◽  
Tibial Pilon ◽  
Early Primary ◽  
Pilon Fractures

scholarly journals Intra- and interobserver agreement on the Oestern and Tscherne classification of soft tissue injury in periarticular lower-limb closed fractures

2014 ◽  
pp. 173-178 ◽  
Author(s):  
Carlos Oliver Valderrama-Molina ◽  
Mauricio Estrada-Castrillón ◽  
Jorge Andres Hincapie ◽  
Luz Helena Lugo-Agudelo
Keyword(s):  
Soft Tissue ◽  
Tibial Plateau ◽  
Interobserver Agreement ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Case Series ◽  
Lower Extremities ◽  
Tibial Pilon ◽  
Pilon Fractures

Background: The soft tissues injury in periarticular fractures of the lower extremities determines the proper time to perform bone fixation. Objetive: The aim of this study was to determine the intra and interobserver agreement in the Tscherne classification. Methods: This is a descriptive, prospective study for patients admitted to the Pablo Tobón Uribe Hospital (PTUH) with tibial plateau or tibial pilon fractures. We performed a standardize evaluation using video photography at the time of admission and 24, 48, and 72 h after admission. Fifteen five reviewers who had various levels of training produced a total of 1,200 observations. The intra- and interobserver agreement was assessed using a weighted kappa for multiple raters and more than two categories. Results: Twenty patients were admitted with tibial plateau and tibial pilon fractures. The intraobserver agreement for all 15 raters was kappa 0.81 (95% CI 0.79-0.83), and the interobserver agreement for all 15 raters was kappa 0.65 (95% CI 0.55-0.73). The interobserver agreement at 24 h was kappa 0.67 (95% CI 0.46-0.86). Conclusions:Classifying the severity of soft tissue injury is critical in planning the surgical management of fractures of the lower extremities. Based on our results, we can reasonably argue that the Tscherne classification produced an adequate level of agreement and could be used to standardize and to guide the treatment, and to conduct research studies. Level of Evidence: Level IV, Case Series

A Operative Treatment of the Tibial Pilon Fractures : For minimize soft tissue injury

1997 ◽  
Vol 10 (2) ◽  
pp. 346
Author(s):  
Jae Do Kang ◽  
Kwang Yul Kim ◽  
Hyung Chun Kim ◽  
Moon Sub Yim ◽  
Sang Hoon Ko
Keyword(s):  
Soft Tissue ◽  
Operative Treatment ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Tibial Pilon ◽  
Pilon Fractures
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