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Pilon fractures

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https://www.readbyqxmd.com/read/28504809/effect-of-lymphedema-treatment-for-management-of-acute-pilon-fractures
#1
John M Whatley, James A Lalonde, Craig C Greene, Kevin B Riche, Danielle M Tatum
Pilon fractures are high-energy injuries that often result in considerable edema and compromise of the soft tissue envelope of the ankle. These injuries are typically staged with an external fixator until the soft tissue is amenable for definitive fixation. This study was conducted to determine the effects of lymphedema treatment for the management of pilon fractures. Patients who underwent open reduction and internal fixation of pilon fractures between 2007 and 2014 at the authors' level II trauma center were identified by Current Procedural Terminology codes indicative of placement of an external fixator (20690) and open reduction and internal fixation of a pilon fracture (27826, 27827, or 27828)...
May 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28476393/is-it-worth-discriminating-against-patients-who-smoke-a-systematic-literature-review-on-the-effects-of-tobacco-use-in-foot-and-ankle-surgery
#2
REVIEW
Jason H Kim, Sandeep Patel
Although numerous studies have linked smoking with lower extremity wound and bone healing complications, a comprehensive study on the effects of smoking in foot and ankle surgery has not yet been reported. The purpose of the present study was to report the results of our systemic literature review, identifying the effects of tobacco use on common foot and ankle procedures. The systematic literature review was performed according to guidelines set by the PRIMSA statement (Preferred Reporting Items for Systematic Review and Meta-Analyses)...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28461913/high-energy-pilon-fractures-management-state-of-the-art
#3
REVIEW
Jordi Tomás-Hernández
High-energy pilon fractures are challenging injuries. Multiple options are described for the definitive surgical management of these fractures, but there is no level I evidence for optimal management. The current management and recommendations for treatment will be reviewed in this article.Anatomical reduction of the fracture, restoration of joint congruence and reconstruction of the posterior column with a correct limb axis minimising the soft-tissue insult are the key points to a good outcome when treating pilon fractures...
October 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28458472/plating-of-pilon-fractures-based-on-the-orientation-of-the-fibular-shaft-component-a-biomechanical-study-evaluating-plate-stiffness-in-a-cadaveric-fracture-model
#4
Gennadiy A Busel, J Tracy Watson
OBJECTIVES: To evaluate mechanically superior method of pilon fracture fixation by comparing axial stiffness between anterolateral and medial tibial locking plates in a cadaveric fracture model. METHODS: Eight matched pairs of fresh frozen cadaver specimens (lower limb after through-knee disarticulation) were used to eliminate confounder of bone quality. Simulated pilon fractures were created so that each pair represented either varus or valgus fracture pattern (AO 43-A2) with associated fibular fractures (transverse or comminuted)...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28400871/results-of-arthroscopic-ankle-arthrodesis-with-fixation-using-two-parallel-headless-compression-screws-in-a-heterogenic-group-of-patients
#5
Lukas Kolodziej, Boguslaw Sadlik, Sebastian Sokolowski, Andrzej Bohatyrewicz
BACKGROUND: As orthopedic surgeons become skilled in ankle arthroscopy technique and evidence -based data is supporting its use, arthroscopic ankle arthrodesis (AAA) will likely continue to increase, but stabilization methods have not been described clearly. We present a technique for two parallel 7.3-mm headless compression screws fixation (HCSs) for AAA in cases of ankle arthritis with different etiology, both traumatic and non-traumatic, including neuromuscular and inflammatory patients...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28365167/outcomes-of-the-ilizarov-frame-use-in-elderly-patients
#6
Efthymios Iliopoulos, Natasha Morrissey, Seok Cho, Arshad Khaleel
AIM: The use of circular frame is widely accepted. This is an outcome review on use of circular Ilizarov frame in elderly patients. MATERIALS & METHODS: Data from all patients treated with an Ilizarov circular frame between January 2002 and December 2014, who were 65 years of age or over at surgery was collected. Seventy Ilizarov circular frames were applied during this period in our unit at a mean age of 71.2 years. Clinical, radiological and quality of life questionnaire (SF-12) data were gathered...
March 30, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28365069/quality-of-life-and-prognostic-factors-after-intra-articular-tibial-pilon-fracture
#7
Jorge De-Las-Heras-Romero, Ana M Lledo-Alvarez, Alejandro Lizaur-Utrilla, Fernando A Lopez-Prats
BACKGROUND: Intra-articular tibial plafond fractures are a challenge for the surgeon with generally poor functional outcomes. The purpose was to assess the impact of this injury on patient quality of life (QOL), as well as analyzed the predictor factors. METHODS: Retrospective study of 47 patients with mean age of 44.4 (range 18-79) years. Patients were also invited for new clinical and radiological assessments. QOL was evaluated by the Short Form-36 questionnaire and compared to the standard in the age-matched general population...
March 22, 2017: Injury
https://www.readbyqxmd.com/read/28359592/clinical-efficacy-and-safety-of-limited-internal-fixation-combined-with-external-fixation-for-pilon-fracture-a-systematic-review-and-meta-analysis
#8
Shao-Bo Zhang, Yi-Bao Zhang, Sheng-Hong Wang, Hua Zhang, Peng Liu, Wei Zhang, Jing-Lin Ma, Jing Wang
PURPOSE: To compare the clinical efficacy and complications of limited internal fixation combined with external fixation (LIFEF) and open reduction and internal fixation (ORIF) in the treatment of Pilon fracture. METHODS: We searched databases including Pubmed, Embase, Web of science, Cochrane Library and China Biology Medicine disc for the studies comparing clinical efficacy and complications of LIFEF and ORIF in the treatment of Pilon fracture. The clinical efficacy was evaluated by the rate of nonunion, malunion/delayed union and the excellent/good rate assessed by Mazur ankle score...
April 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28337901/cardiopathy-and-osteoporosis-the-epidemiology-in-a-region-of-italy
#9
A Notarnicola, G Maccagnano, L Moretti, S Tafuri, B Moretti
Cardiopathies and osteoporosis are inter-related due to pathogenetic, hormonal, genetic features as well as an increased risk of fragility. An important feature is attributed to the process of atherosclerosis, which is responsible for an osteopenia effect and degeneration of vascular walls. To date the study populations have been limited. To verify the incidence of cardio-vascular disease in a larger osteoporotic population, we designed a retrospective clinical study analyzing the “Hospital Discharge Data” (HDD) in Apulia between 2006 and 2010...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28336099/direct-fixation-of-fractures-of-the-posterior-pilon-via-a-posteromedial-approach
#10
Harm Hoekstra, Wouter Rosseels, Stefan Rammelt, Stefaan Nijs
The treatment of fractures of the posterior pilon is a timely issue. Restoration of the integrity of the incisura fibularis and subsequent anatomic reduction of the fibula are essential for reconstruction of the ankle mortise after trauma, and syndesmotic stability. Inappropriate treatment ultimately will lead to a poor functional outcome and quality of life. Open reduction and direct internal fixation through a posterolateral or posteromedial approach are increasingly preferred over indirect reduction and anteroposterior screw fixation...
March 19, 2017: Injury
https://www.readbyqxmd.com/read/28323798/supplemental-perioperative-oxygen-to-reduce-surgical-site-infection-after-high-energy-fracture-surgery-oxygen-study
#11
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Robert A Sikorski, Armagan Dagal, Clinton K Murray, Michael J Weaver, Ebrahim Paryavi, Alec C Stall, Daniel O Scharfstein, Julie Agel, Mary Zadnik, Michael J Bosse, Renan C Castillo
Supplemental perioperative oxygen (SPO) therapy has been proposed as one approach for reducing the risk of surgical site infection (SSI). Current data are mixed regarding efficacy in decreasing SSI rates and hospital inpatient stays in general and few data exist for orthopaedic trauma patients. This study is a phase III, double-blind, prospective randomized clinical trial with a primary goal of assessing the efficacy of 2 different concentrations of perioperative oxygen in the prevention of SSIs in adults with tibial plateau, pilon (tibial plafond), or calcaneus fractures at higher risk of infection and definitively treated with plate and screw fixation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323797/local-antibiotic-therapy-to-reduce-infection-after-operative-treatment-of-fractures-at-high-risk-of-infection-a-multicenter-randomized-controlled-trial-vanco-study
#12
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Clinton K Murray, Lauren E Allen, Daniel O Scharfstein, Joshua L Gary, Michael J Bosse, Renan C Castillo
A number of clinical studies in the spine literature suggest that the use of local vancomycin powder may substantially reduce surgical site infections (SSIs). These studies are primarily retrospective and observational and few focus on orthopaedic trauma patients. This study is a phase III, prospective, randomized, clinical trial to assess the efficacy of locally administered vancomycin powder in the prevention of SSI after fracture surgery. The primary goal of the VANCO Study is to compare the proportion of deep SSI 6 months after fracture fixation surgery...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323767/how-to-get-to-the-distal-posterior-tibial-malleolus-a-cadaveric-anatomic-study-defining-the-access-corridors-through-3-different-approaches
#13
Mathieu Assal, Miki Dalmau-Pastor, Adrien Ray, Richard Stern
OBJECTIVE: Our objective is to review the anatomy and exposure of the posterior column and posterior tibial malleolus (the posterior tibial plafond) by defining the access corridors through 3 different approaches-posteromedial, posterolateral, and modified posteromedial. METHODS: Cadaveric dissection with percentage of posterior tibial malleolus exposed, and strain gauge measurements to evaluate traction on the neurovascular bundle. RESULTS: The 3 different approaches are applicable for exposure of different portions of the distal posterior tibial malleolus...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28288519/evaluation-of-fibular-fracture-type-vs-location-of-tibial-fixation-of-pilon-fractures
#14
Gennadiy A Busel, J Tracy Watson, Heidi Israel
BACKGROUND: Comminuted fibular fractures can occur with pilon fractures as a result of valgus stress. Transverse fibular fractures can occur with varus deformation. No definitive guide for determining the proper location of tibial fixation exists. The purpose of this study was to identify optimal plate location for fixation of pilon fractures based on the orientation of the fibular fracture. METHODS: One hundred two patients with 103 pilon fractures were identified who were definitively treated at our institution from 2004 to 2013...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28271932/mid-term-results-of-minimally-invasive-plate-osteosynthesis-and-circular-external-fixation-in-the-treatment-of-complex-distal-tibia-fractures
#15
Yunus Imren, Engin Eren Desteli, Mehmet Erdil, Hasan Hüseyin Ceylan, Ibrahim Tuncay, Cengiz Sen
BACKGROUND: The treatment of pilon tibia fractures is challenging. Anatomical reduction of the joint surface is essential. Excessive soft-tissue dissection may interfere with the blood supply and can result in nonunion. We sought to compare the outcomes of distal tibia fractures treated with medial locking plates versus circular external fixators. METHODS: We retrospectively evaluated 41 consecutive patients with closed pilon tibia fractures treated with either minimally invasive locking plate osteosynthesis (n = 21) or external fixation (EF) (n = 20)...
January 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28253941/arthrodesis-of-the-ankle
#16
H Zwipp
About 90 % of all cases of painful posttraumatic ankle arthritis can be very successfully treated with a minor invasive ankle arthrodesis technique by using a small anterior approach and a fixation with four 6. 5 mm screws of which the posteromedial and transfibular one are inserted percutaneously. The results with this standardized procedure have been reported previously as excellent and good in a mid-term run of 6 years (34). This technique leads to a high union rate of 99% (92 of 93) with rapid bone healing within 8 ± 2 weeks, it causes a low minor complication rate of 8 % and enables a significant increase of the AOFAS ankle/hindfoot score (17) from 36 preoperatively to 85 postoperatively as well as a midtarsal movement of 24° ± 16°...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28167059/primary-arthrodesis-for-tibial-pilon-fractures
#17
REVIEW
Bryant Ho, John Ketz
Staged primary ankle arthrodesis is a viable option for high-energy pilon fractures that are nonreconstructible, in patients with delay in treatment or multiple medical comorbidities, or in patients with peripheral neuropathy. Small retrospective series demonstrate high union and low wound complication rates, although further studies are needed to determine the long-term results. Ankle arthrodesis offers decreased complication rates while eliminating the potential of posttraumatic ankle arthritis pain.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28159051/an-uncommon-case-of-irreducible-ankle-fracture-dislocation-the-bosworth-like-tibio-fibular-fracture
#18
Michele Cappuccio, Danilo Leonetti, Berardo Di Matteo, Domenico Tigani
An irreducible ankle-fracture dislocation characterized by the dislocation of the proximal fragment of the fibula posteriorly to the tibial tubercle is defined as "Bosworth injury". In the present report it is described, for the first time in literature, a complex case where the Bosworth injury was associated to a tibial plafond fracture: the proximal fibular fragment was entrapped between the tibial pilon and the fractured posterior tibial tubercle, which acted as a clamp, thus avoiding ankle reduction. Due to the presence of the tibial fracture, it was not possible to observe the typical radiological signs of Bosworth injury and therefore two unsuccessful reductions were attempted before performing a CT scan that revealed the complexity of the case, that required an immediate ORIF procedure to prevent the onset of complications...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28112555/incidence-and-association-of-ct-findings-of-ankle-tendon-injuries-in-patients-presenting-with-ankle-and-hindfoot-fractures
#19
Ashkahn Golshani, Liang Zhu, Chunyan Cai, Nicholas M Beckmann
OBJECTIVE: Tendon injuries are a commonly encountered finding in ankle CT examinations performed for fractures. This study was designed to identify the incidence and associations of tendon injuries in ankle CT examinations performed for fractures. MATERIALS AND METHODS: A retrospective review was performed of 410 patients who underwent ankle CT during a 6-year period. RESULTS: Tendon injuries were common, seen in 25% of all ankle CT examinations...
February 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28103707/predictors-of-patient-reported-function-and-pain-outcomes-in-operative-ankle-fractures
#20
Daniel M Dean, Bryant S Ho, Albert Lin, Daniel Fuchs, George Ochenjele, Bradley Merk, Anish R Kadakia
BACKGROUND: Risk factors associated with short-term functional outcomes in patients with operative ankle fractures have been established. However, no previous studies have reported the association between these risk factors and functional outcomes outside of the first postoperative year. We identified predictors of functional and pain outcomes in patients with operative ankle fractures using the Patient Reported Outcomes Measurement System (PROMIS) physical function (PF) and pain interference (PI) measures...
May 2017: Foot & Ankle International
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