Comparison Between the Modified External Fixation and Calcaneal Traction in Ruedi-Allgower Type II/III Pilon Fractures

Twenty-one patients with severe tibial plafond fractures were treated by unilateral large screw external fixation. In 15 patients, this was combined with limited internal fixation. The fractures were classified according to the methods of Ovadia and Beals. 12 There were nine type lll, four type IV, and eight type V fractures, and according to the methods of Rüedi and Allgöwer, nine type II and 12 type III fractures. Seven fractures were open. In five fractures, no attempt was made at articular reconstruction due to severe comminution. Four of these fractures required ankle arthrodeses and one type IIIB fracture received a late amputation. All other fractures healed. There were no cases of wound infection, skin slough, or osteomyelitis. Large screw external fixation in the talus and calcaneus was not associated with significant early or late complications. The less extensive tissue dissection in an area prone to wound complications may account for the low rates of infections, wound complications, and nonunion.

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Evaluation of functional outcome of pilon fractures managed with limited internal fixation and external fixation: A prospective clinical study

Journal of Clinical Orthopaedics and Trauma ◽

10.1016/j.jcot.2017.05.005 ◽

2017 ◽

Vol 8 ◽

pp. S16-S20 ◽

Cited By ~ 2

Author(s):

Umesh Kumar Meena ◽

Mahesh Chand Bansal ◽

Prateek Behera ◽

Rahul Upadhyay ◽

Gyan Chand Gothwal

Keyword(s):

Clinical Study ◽

Internal Fixation ◽

Functional Outcome ◽

External Fixation ◽

Prospective Clinical Study ◽

Pilon Fractures

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External Fixation of Severely Comminuted and Open Tibial Pilon Fractures

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199307000-00012 ◽

1993 ◽

Vol 292 ◽

pp. 101-107 ◽

Cited By ~ 167

Author(s):

LAWRENCE BONE ◽

PHILIP STEGEMANN ◽

KEVIN MCNAMARA ◽

ROGER SEIBEL

Keyword(s):

External Fixation ◽

Tibial Pilon ◽

Pilon Fractures

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Arthroscopic-Assisted External Fixation of Pilon Fractures

Intraarticular Fractures ◽

10.1007/978-3-319-97602-0_37 ◽

2019 ◽

pp. 333-339

Author(s):

Aristotelis T. Fylaktos ◽

Andreas G. Tsantes ◽

Dimitrios V. Papadopoulos ◽

Stefanos C. Papageorgiou ◽

Dimitrios Kosmas ◽

...

Keyword(s):

External Fixation ◽

Pilon Fractures

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Management of mal-united Pilon fractures with joint-sparing osteotomy

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00527 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0052

Author(s):

Guang-rong Yu

Keyword(s):

Type Ii ◽

Foot And Ankle ◽

Aofas Score ◽

Vas Score ◽

Articular Surfaces ◽

Significant Difference ◽

The Mean ◽

American Orthopaedic ◽

Time From Injury ◽

Pilon Fractures

Category: Ankle Introduction/Purpose: To explore the effectiveness and operative methods to treat various mal-united Pilon fractures with joint-sparing osteotomy. Methods: Between January 2011 and October 2016, 21 patients with mal-united Pilon fractures were treated with joint-sparing osteotomy. There were 13 males and 8 females with an average age of 38.4 years (range, 22-48 years). 14 were left feet and 7, right. The time from injury to reconstructive operation was 4 months to 10 years. 17 received operative treatment previously, and 4 were treated by plaster fixation. According to Rüedi-Allgöwer classification, 16 were rated as type II (including 6 medial Pilon fractures, 5 anterior, 5 posterior) and 5, type III. All patients received standardized postoperative managements. Results: All patients were followed up for more than 1 year. All the fractures were reunited in an average time of 13.8 weeks (range 9 to 18 weeks). The mean visual analogue scale (VAS) score was 2.42 (range 0 to 5) and the mean ankle and hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS) score was 78.81(range 65 to 92) 6 months after operation. The VAS score was 5.27 (range 2 to 7) and the AOFAS score was 57.26 (range 20 to 81) before. Comparing to preoperative data, statistically significant difference was found postoperatively (P<0.05). Conclusion: Results by joint-sparing osteotomy to realign and reconstruct articular surfaces of ankles are acceptable. Functions and symptoms are improved significantly after operation. Joint-sparing osteotomy can be a considerable option for treating mal-united Pilon fractures.

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Emergency Room External Fixation of Tibial Pilon Fractures

Techniques in Foot & Ankle Surgery ◽

10.1097/00132587-200212000-00010 ◽

2002 ◽

Vol 1 (2) ◽

pp. 151-157

Author(s):

JOSEPH A. IZZI ◽

RAHUL BANERJEE ◽

ANDREW H. SMITH ◽

RICHARD L MCGOUGH ◽

CHRISTOPHER W. DIGIOVANNI

Keyword(s):

Emergency Room ◽

External Fixation ◽

Tibial Pilon ◽

Pilon Fractures

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

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.08.001 ◽

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.

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