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https://www.readbyqxmd.com/read/28167059/primary-arthrodesis-for-tibial-pilon-fractures
#1
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
#2
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
#3
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
#4
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...
January 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28090442/can-mri-accurately-detect-pilon-articular-malreduction-a-quantitative-comparison-between-ct-and-3t-mri-bone-models
#5
Shairah Radzi, Constantin Edmond Dlaska, Gary Cowin, Mark Robinson, Jit Pratap, Michael Andreas Schuetz, Sanjay Mishra, Beat Schmutz
BACKGROUND: Pilon fracture reduction is a challenging surgery. Radiographs are commonly used to assess the quality of reduction, but are limited in revealing the remaining bone incongruities. The study aimed to develop a method in quantifying articular malreductions using 3D computed tomography (CT) and magnetic resonance imaging (MRI) models. METHODS: CT and MRI data were acquired using three pairs of human cadaveric ankle specimens. Common tibial pilon fractures were simulated by performing osteotomies to the ankle specimens...
December 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28041949/comparison-of-early-adverse-events-after-operative-treatment-of-bimalleolar-and-trimalleolar-fractures-versus-pilon-fractures
#6
Karim Z Masrouha, Hani Tamim, Assad Taha, Abdel Majid Sheikh Taha, Racha Abi-Melhem, Muhyeddine Al-Taki
Ankle fractures requiring open reduction and internal fixation vary in severity from unimalleolar fractures to bimalleolar/trimalleolar (BT) fractures to pilon fractures. Consequently, the postoperative outcomes with these surgeries can vary. Most previous studies of these injuries had small sample sizes, studied a single risk factor or adverse event, or did not compare different injuries by severity. The purpose of the present study was to describe and compare the patient characteristics and postoperative outcomes of 2 high-energy ankle fractures: BT and pilon fractures...
December 29, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28009702/volar-dorsal-and-lateral-locking-plate-fixation-for-pilon-fractures
#7
Mark Henry
The more common dorsal fracture subluxations at the base of the middle phalanx have an intact dorsal buttress of articular surface in continuity with the shaft. Capitalizing on this foundation, various fixation methods have met with relatively equivalent success including Kirschner wires, screws only, nonlocking plate and screws, and external fixation. Pilon fractures are complete articular fractures, where the comminuted articular fragments lack any structural connection to the more distal shaft of the middle phalanx, and have largely relied upon external fixation traction systems...
March 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27997468/locking-compression-pilon-plate-for-fixation-of-comminuted-posterior-wall-acetabular-fractures-a-novel-technique
#8
Adam K Lee, Benjamin R Wagner, Kristin McPhillips, Daniel S Horwitz, James C Widmaier
Posterior wall acetabular fractures involving a large portion the wall's width and with extensive comminution are difficult fractures to manage operatively. Cortical substitution with a pelvic reconstruction plate and supplemental spring plates has been the traditional means of fixation for these fractures. This option, however, requires the use of multiple, unlinked plates and provides no reliable option for peripheral fixation in comminuted fragments. We describe a novel technique for operative fixation of large, comminuted posterior wall fractures using a single distal tibia pilon plate with the option for peripheral locking screw fixation and report on a series of 20 consecutive patients treated with this method...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27942740/primary-ankle-arthrodesis-for-severely-comminuted-tibial-pilon-fractures
#9
Mohamed E Al-Ashhab
Management of severely comminuted, complete articular tibial pilon fractures (Rüedi and Allgöwer type III) remains a challenge, with few treatment options providing good clinical outcomes. Twenty patients with severely comminuted tibial pilon fractures underwent primary ankle arthrodesis with a retrograde calcaneal nail and autogenous fibular bone graft. The fusion rate was 100% and the varus malunion rate was 10%. Fracture union occurred at a mean of 16 weeks (range, 13-18 weeks) postoperatively. Primary ankle arthrodesis is a successful method for treating highly comminuted tibial pilon fractures, having a low complication rate and a high satisfaction score...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27917329/minimally-invasive-treatment-of-tibial-pilon-fractures-through-arthroscopy-and-external-fixator-assisted-reduction
#10
Huasong Luo, Liaobin Chen, Kebin Liu, Songming Peng, Jien Zhang, Yang Yi
OBJECTIVE: The aim of this study was to evaluate the clinical outcome of tibial pilon fractures treated with arthroscopy and assisted reduction with an external fixator. METHODS: Thirteen patients with tibial pilon fractures underwent assisted reduction for limited lower internal fixation with an external fixator under arthroscopic guidance. The weight-bearing time was decided on the basis of repeat radiography of the tibia 3 months after surgery. Postoperative ankle function was evaluated according to the Mazur scoring system...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27891412/revisited-a-prospective-study-on-functional-outcome-of-internal-fixation-of-tibial-pilon-fractures-with-locking-plate-using-mipo
#11
Rashid Anjum, Vikas Choudhary, Vivek Sharma
No abstract text is available yet for this article.
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27872380/management-of-distal-tibial-metaphyseal-bone-defects-with-an-intramedullary-nitinol-scaffold-a-novel-technique
#12
Samuel E Ford, J Kent Ellington
: Difficult problems that are faced when reconstructing severe pilon fractures include filling metaphyseal defects and supporting an impacted, multifragmented articular surface. Supplements to plate fixation currently available in a surgeon's armamentarium include cancellous bone autograft, structural bone allograft, demineralized bone matrix, and calcium-based cements. Cancellous autograft possesses limited inherent mechanical stability and is associated with graft site morbidity. Structural allografts incorporate inconsistently and are plagued by late resorption...
November 20, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27870672/the-clinical-and-economic-impact-of-generic-locking-plate-utilization-at-a-level-ii-trauma-center
#13
Austin Mcphillamy, Taylor P Gurnea, Alastair E Moody, Christopher G Kurnik, Minggen Lu
OBJECTIVES: In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27797787/re-evaluation-of-low-intensity-pulsed-ultrasound-in-treatment-of-tibial-fractures-trust-randomized-clinical-trial
#14
Jason W Busse, Mohit Bhandari, Thomas A Einhorn, Emil Schemitsch, James D Heckman, Paul Tornetta, Kwok-Sui Leung, Diane Heels-Ansdell, Sun Makosso-Kallyth, Gregory J Della Rocca, Clifford B Jones, Gordon H Guyatt
OBJECTIVE:  To determine whether low intensity pulsed ultrasound (LIPUS), compared with sham treatment, accelerates functional recovery and radiographic healing in patients with operatively managed tibial fractures. DESIGN:  A concealed, randomized, blinded, sham controlled clinical trial with a parallel group design of 501 patients, enrolled between October 2008 and September 2012, and followed for one year. SETTING:  43 North American academic trauma centers...
October 25, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27780508/external-fixation-versus-open-reduction-and-internal-fixation-for-tibial-pilon-fractures-a-meta-analysis-based-on-observational-studies
#15
Yi-Chen Meng, Xu-Hui Zhou
PURPOSE: Tibial pilon fractures remain challenging for an orthopaedic surgeon to repair. External fixation (ExFix) and open reduction and internal fixation (ORIF) are two widely used methods for repairing tibial pilon fractures. However, conclusions of comparative studies regarding which method is superior are controversial. Our aim is to compare ORIF and ExFix and clarify which method is better in terms of reduction and union results and major complications. METHODS: A computerized research of MEDLINE, EMBASE, Springer, and Cochrane Library (before December 2014) for studies of any design comparing ORIF and ExFix was conducted...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27768658/the-military-orthopedic-trauma-registry-the-potential-of-a-specialty-specific-process-improvement-tool
#16
Jessica C Rivera, Renee M Greer, Mary Ann Spott, Anthony E Johnson
BACKGROUND: The Military Orthopaedic Trauma Registry (MOTR) was designed to replicate the Department of Defense Trauma Registry's (DoDTR's) role as pillar for data-driven management of extremity war wounds. The MOTR continuously undergoes quality assurance checks to optimize the registry data for future quality improvement efforts. We conducted a quality assurance survey of MOTR entrants to determine if a simple MOTR data pull could provide robust orthopedic-specific information toward the question of causes for late amputation...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27768629/fibular-fixation-in-distal-tibia-fractures-reduction-aid-or-nonunion-generator
#17
Daniel Torino, Samir Mehta
The role of fibular fixation in patients with distal tibia fractures is controversial. Although the stability of the fibula is critical in patients with syndesmotic instability or highly comminuted pilon fractures, fibular fixation in extraarticular distal tibia fractures or elementary intraarticular distal tibia fractures is more controversial. Biomechanical studies, as performed in sawbones or cadaveric models, denote advantages to fibular fixation with respect to specific uniplanar motion. However, the increased stability is susceptible to the fracture pattern of the tibia, fixation strategy for the tibia, fixation strategy for the fibula, and loading pattern of the entire construct...
November 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27763960/does-a-staged-posterior-approach-have-a-negative-effect-on-ota-43c-fracture-outcomes
#18
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared with a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
February 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27756830/the-use-of-dynamic-external-fixation-in-the-treatment-of-dorsal-fracture-subluxations-and-pilon-fractures-of-finger-proximal-interphalangeal-joints
#19
M M Abou Elatta, F Assal, H M Basheer, A F El Morshidy, S M Elglaind, M A Abdalla
: The aim of this study was to review the outcome of the treatment of finger proximal interphalangeal joint dorsal fracture subluxations and pilon fractures with a modified external fixator. We treated 36 patients (36 fingers). We assessed the ranges of motion and patient satisfaction. At final follow-up, 23 patients had no pain; 11 had pain in the cold; and two also had mild pain. None had moderate or severe pain. The mean range of proximal interphalangeal joint motion was 86° (60°-100°)...
February 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27599821/-3d-safety-in-osteosynthesis-adjacent-to-joints
#20
J Franke, S Y Vetter, N Beisemann, B Swartman, P A Grützner, M Schnetzke
BACKGROUND: The results and immediate consequences of intraoperative three-dimensional (3D) imaging in the treatment of AO classification type C fractures of the distal radius, the tibial head and the tibial pilon were analyzed and compared with published results on general intraoperative revision rates following intraoperative 3D-imaging. METHODS: In this retrospective study 279 patients with AO type C fractures of the distal radius (n = 84), tibial head (n = 109) and tibial pilon (n = 86) who underwent intraoperative 3D-imaging were included...
October 2016: Der Unfallchirurg
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