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Pilon fractures

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https://www.readbyqxmd.com/read/28717978/-treatment-strategy-and-planning-for-pilon-fractures
#1
REVIEW
Thomas Mittlmeier, Alice Wichelhaus
BACKGROUND: Pilon fractures are mainly severe and prognostically serious injuries with a high rate of relevant soft tissue involvement. The adequate decision making and choice of treatment in the early phase of trauma are of paramount importance for the final outcome. This essentially encompasses the management of the soft tissue damage, the surgical planning and the differentiated selection of procedures. GOALS/MATERIAL AND METHODS: Most concepts of staged treatment nowadays offer a wide range of options which are integrated into expert-based algorithms...
July 17, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28697082/primary-posterior-blade-plate-tibiotalar-arthrodesis-a-salvage-procedure-for-complex-nonreconstructable-pilon-fractures
#2
Ermias Abebe, Dana J Farrell, Boris Zelle, Gary Gruen
A subset of C2/C3 pilon fractures, open pilon injuries, metaphyseal bone comminution, and those involving substantial soft tissue or vascular injury may be nonreconstructable. Such injuries are at risk of progress to nonunion and failing open reduction internal fixation (ORIF). The risk of infection, malunion, and nonunion is relatively high with such injury patterns. In such cases, tibiotalar arthrodesis is performed after ORIF fails as a salvage procedure. Overall, the literature agrees that all pilon fractures will develop posttraumatic osteoarthritis, and these patients are ultimately treated with an arthrodesis or in narrow population with total ankle arthroplasty...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28674752/-operative-access-for-treatment-of-pilon-fractures
#3
REVIEW
K Klaue
BACKGROUND: Under optimal conditions, fractures of the tibial pilon can be definitively managed operatively within 6 h after the trauma. Under suboptimal conditions, preoperative antiphlogistic treatment, possibly after approximate correction and external fixation of the alignment, is a reasonable option. Osteosynthesis implies reconstruction of good joint congruency in anatomical orientation. The soft tissue coverage of the distal lower leg is relatively poorly constructed and there is a high risk of devascularization, necrosis and ensuing infection...
July 3, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28645549/staged-treatment-of-infected-tibiotalar-fusion-using-a-combination-antibiotic-spacer-and-antibiotic-coated-intramedullary-nail
#4
Justin Miller, Victor Hoang, Richard S Yoon, Frank A Liporace
Pilon fractures are notoriously difficult injuries to treat. The current published data on salvage procedures after failed pilon fractures includes both total ankle arthroplasty (TAA) and tibiotalar fusion, each with its own specific indications. However, no acceptable treatment algorithm addressing the complications of these limb salvage procedures is available. We present the case of a 23-year-old patient, who sustained a complex pilon fracture after a motor vehicle accident. The patient was referred to our institution after an initial fixation attempt, followed by subsequent failed TAA, which was complicated by an infected fusion attempt...
June 20, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28638931/-operative-techniques-and-results-of-tibial-pilon-fractures
#5
REVIEW
R Rotter, P Gierer
BACKGROUND: The anatomical reconstruction of tibial pilon fractures is a major challenge with respect to preoperative planning, time management and the intraoperative procedure. OBJECTIVE: Presentation of the various surgical procedures available and the clinical outcome. MATERIAL AND METHODS: The established open reduction and internal plate fixation procedures form the basis for new minimally invasive treatment concepts. The current results of comparative studies and basic literature are discussed...
June 21, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28633772/omnidirectional-internal-fixation-by-double-approaches-for-treating-r%C3%A3-edi-allg%C3%A3-wer-type-iii-pilon-fractures
#6
Chong-Hua Dai, Jun Sun, Kun-Quan Chen, Hui-Bo Zhang
In the present study, we explored the effectiveness and complications of omnidirectional internal fixation using a double approach for treating Rüedi-Allgöwer type III pilon fractures. A retrospective analysis was performed of 19 cases of Rüedi-Allgöwer type III unilateral closed pilon fracture. With preoperative preparation and correct surgical timing, the reduction was performed using anteromedial and posterolateral approaches, and the fracture fragments were fixed by omnidirectional internal fixation...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28629769/the-correlation-of-the-morphological-changes-of-ankle-point-and-ankle-joint-function-after-surgery-on-the-ruedi-allgouer-type-iii-pilon-fracture-a-case-series-study
#7
Yifei Zhou, Leyi Cai, Xiaolang Lu, Yang Yu, Jianjun Hong
BACKGROUND: To analyze the relationship between imaging findings and postoperative curative effect by measuring the morphology of the ankle mortise in patients with the Ruedi-Allgouer type III Pilon fractures. MATERIAL AND METHODS: Forty-seven patients with Ruedi-Allgouer type III Pilon fractures who underwent surgical treatment from January 2011 to January 2015 were retrospectively analyzed. At the last follow-up, x-rays of the affected ankle and the healthy side were measured...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28606840/open-reduction-in-pilon-variant-posterior-malleolar-fractures-radiological-and-clinical-evaluation
#8
Erhan Sukur, Yunus Emre Akman, Huseyin Bahadır Gokcen, Esra Circi Ozyurek, Ahmet Senel, Yusuf Ozturkmen
BACKGROUND: Pilon variant posterior malleolar (PVPM) fractures significantly disrupt joint congruency and cause tibiotalar instability. They are often underestimated and inadequately treated. PURPOSE: This study assessed the outcomes of surgical treatment of this subtype of malleolar fracture, and examined the importance of computed tomography (CT) in diagnosis and surgical treatment. MATERIAL AND METHODS: CT images and radiographs of 67 patients with trimalleolar ankle fractures were retrospectively analyzed...
June 9, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28567532/-pilon-fractures-review-of-diagnostics-and-classification
#9
REVIEW
U Wiebking
Intraarticular fractures of the distal tibia (pilon fractures) are rare injuries and today they occur mostly in traffic accidents and falls from a great height. There are simple fractures in the context of low-energy traumas, as well as complex comminuted fractures in high-energy traumas. Besides the clinical examination, plain radiographs and computed tomographic scans are diagnostic prerequisites. The aim of the diagnostic process is to clearly identify and classify the fracture before appropriate treatment is initiated...
May 31, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28540568/-tibial-pilon-fractures-advoidance-and-therapy-of-complications
#10
REVIEW
Ralph Gaulke, Christian Krettek
Because of the complex fracture morphology and vulnerable soft tissue coverage, fractures of the tibial pilon are difficult to treat. Complications are more common than in bi- or trimalleolar fractures. The surgeon has to know about the special risks of these injuries to avoid complications. Early complications are soft tissue necrosis, persisting fragment dislocations after surgery, loss of reposition and deep wound infection. The surgeon has to be aware of early signs of compartment-syndrome and chronic regional pain syndrome (CRPS)...
May 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28504809/effect-of-lymphedema-treatment-for-management-of-acute-pilon-fractures
#11
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)...
July 1, 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
#12
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
#13
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 reviews
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
#14
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
#15
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
#16
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
#17
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...
June 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
#18
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
#19
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
#20
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...
June 2017: Injury
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