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pilon fracture surgery

David Hardeski, Greg Gaski, Manjari Joshi, Richard Venezia, Jason W Nascone, Marcus F Sciadini, Robert V O'Toole
BACKGROUND: Temporary external fixators are often used to stabilize fractures when definitive fracture surgery must be delayed. Sometimes, external fixators are left in place during repeat operations, including definitive internal fixation of tibial pilon and tibial plateau fractures. It is unknown how well current surgical preparation sterilizes these devices, which become part of the surgical field. Our hypothesis was that our institution's standard surgical preparation creates a low rate of culture-positive environments on external fixators at the time of surgical skin incision...
December 2016: Injury
Mareen Braunstein, Sebastian F Baumbach, Markus Regauer, Wolfgang Böcker, Hans Polzer
BACKGROUND: An anatomical reconstruction of the ankle congruity is the important prerequisite in the operative treatment of acute ankle fractures. Despite anatomic restoration patients regularly suffer from residual symptoms after these fractures. There is growing evidence, that a poor outcome is related to the concomitant traumatic intra-articular pathology. By supplementary ankle arthroscopy anatomic reduction can be confirmed and associated intra-articular injuries can be treated. Nevertheless, the vast majority of complex ankle fractures are managed by open reduction and internal fixation (ORIF) only...
2016: BMC Musculoskeletal Disorders
Y J Zha, X Y Jiang, M Q Gong
OBJECTIVE: To introduce the surgical techniques and treating results of the old "terrible triad" of the elbow. METHODS: A retrospective analysis of 11 cases of old "terrible triad" of the elbow treated by the author from March 2009 to February 2014 were performed, with 9 males and 2 females; mean age was (31.82±8.66) years (17-45 years). The average time after injury was (6.36±2.50) weeks (4-12 weeks), with 7 cases on the left and 4 right. The combined injury included 2 cases with distal radius fractures, 1 with ankle fractures, fractures of the distal radius and the head injury (minor epidural hematoma, no surgery), and 1 with Pilon fractures and L4 fractures (fixed at local hospital)...
April 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
R Gauthé, A Desseaux, L Rony, N Tarissi, F Dujardin
INTRODUCTION: In the elderly, ankle fractures are likely to cause specific complications and have a major impact on their autonomy. The goal of this multicentre study was to assess these outcomes in a geriatric population treated operatively. MATERIAL AND METHODS: This retrospective study included 477 patients with ankle fractures treated surgically between 2008 and 2014. The minimum age was 60years for women and 70 for men. Patients with a tibial pilon fracture or less than 3months' follow-up were excluded...
June 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Zhenhai Wang, Wenqing Qu, Tong Liu, Zhiyong Zhou, Zhongyuan Zhao, Dan Wang, Limin Cheng
Management of type C pilon fractures remains controversial and challenging. The aim of the present study was to provide a 2-stage protocol with vacuum sealing drainage for the treatment of type C pilon fractures. From March 2009 to March 2012, 16 patients (mean age 42.3 years) were admitted to our department with type C pilon fractures and treated with single-stage external fixation and second-stage internal fixation (anteromedial incision) combined with vacuum sealing drainage. The American Orthopaedic Foot and Ankle Society scale score averaged 86...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Hani El-Mowafi, Ahmed El-Hawary, Yasser Kandil
BACKGROUND: Pilon fractures usually result from high energy trauma, and are commonly associated with extensive soft tissue damage which prevents the use of open reduction and internal fixation. PURPOSE: This study was designed to evaluate the use of the Ilizarov external fixator in the treatment of pilon fractures of the ankle, and to determine whether arthroscopy of the ankle could improve the outcome. METHODS: From February 2011 to May 2013 a total of 23 patients with unilateral closed pilon fractures were divided into two groups treated with and without arthroscopy during fixation with the Ilizarov external fixator...
December 2015: Foot
Margaret J Starnes-Roubaud, Mirna Peric, Farshad Chowdry, Joanna T Nguyen, Wesley Schooler, Randolph Sherman, Joseph N Carey
BACKGROUND: Microsurgical reconstruction of the lower extremity is an integral part of the limb salvage algorithm. Success is defined by a pain-free functional extremity, with a healed fracture and sufficient durable soft tissue coverage. Although early flap coverage of lower extremity fractures is an important goal, it is not always feasible because of multiple factors. Between the years 2000 and 2010, approximately 50% of patients at Los Angeles County and University of Southern California Medical Center requiring microsurgical reconstruction did not receive soft tissue coverage until more than 15 days postinjury secondary to primary trauma, physiologic instability, patient comorbidities, or orthopedic and plastic surgery operative backlog...
July 2015: Plastic and Reconstructive Surgery. Global Open
Albert dʼHeurle, Namdar Kazemi, Camille Connelly, John D Wyrick, Michael T Archdeacon, Theodore T Le
OBJECTIVES: To compare the radiographic and functional outcome of patients with high-energy pilon fractures treated with locked versus nonlocked plates. DESIGN: Randomized prospective trial. SETTING: Academic level 1 trauma center. PATIENTS: Between December 2006 and December 2008, 60 consecutive patients with 62 AO/OTA type A, B, and C tibial pilon fractures were enrolled in the study. Thirty-two of the fractures were treated using locked plates and 29 were treated with nonlocked plates...
September 2015: Journal of Orthopaedic Trauma
Tingting Ren, Liang Ding, Feng Xue, Zhimin He, Haijun Xiao
OBJECTIVES: Pilon fracture is a complex injury that is often associated with severe soft tissue damage and high rates of surgical site infection. The goal of this study was to analyze and identify independent risk factors for surgical site infection among patients undergoing surgical fixation of a pilon fracture. METHODS: The medical records of all pilon fracture patients who underwent surgical fixation from January 2010 to October 2012 were reviewed to identify those who developed a surgical site infection...
June 2015: Clinics
Peter Roth, Christian Heiss, Ahmed Koshty, Bernd Niemann, Andreas Boening
Background Cases of posttraumatic arteriovenous (AV) fistula of the distal lower limb are rarely reported. Time from trauma to diagnosis varies from hours to years. Case Description This case report of a 51-year-old male patient shows very impressively the extensive consequences of an unrecognized traumatic AV fistula. The fistula developed here after a car accident led to a massive healing delay in a pilon fracture of the tibia and a wound, resulting in almost 1 year immobilization, 20 operations, and extensive pain drug therapy...
December 2014: Thoracic and Cardiovascular Surgeon Reports
Matthew A Langford, Kevin Cheung, Zhongyu Li
BACKGROUND: Unstable, severely comminuted fractures of the metacarpophalangeal (MCP) joint are difficult to treat. Closed treatment and casting of these fractures often fail to maintain proper alignment and impede wound care where concomitant open injuries such as gunshot wounds are present. Conventional pinning or plating techniques are not feasible if extensive bone loss and comminution are present. A distraction pinning technique represents a potential alternative, but results with this approach, to our knowledge, have not been reported...
September 2015: Clinical Orthopaedics and related Research
Jan Bartoníček, Stefan Rammelt, Karel Kostlivý, Václav Vaněček, Daniel Klika, Ivo Trešl
INTRODUCTION: The aim of this study was to analyze the pathoanatomy of the posterior fragment on the basis of a comprehensive CT examination, including 3D reconstructions, in a large patient cohort. MATERIALS AND METHODS: One hundred and forty one consecutive individuals with an ankle fracture or fracture-dislocation of types Weber B or Weber C and evidence of a posterior tibial fragment in standard radiographs were included in the study. The mean patient age was 49 years (range 19-83 years)...
April 2015: Archives of Orthopaedic and Trauma Surgery
Adam Lomax, Anjani Singh, Madeley N Jane, Kumar C Senthil
BACKGROUND AND AIMS: In this cohort study, we present comprehensive injury specific and surgical outcome data from one of the largest reported series of pilon fractures of the distal tibia treated in a UK tertiary referral centre. METHODS AND RESULTS: A series of 68 closed pilon fractures were retrospectively reviewed from case notes, plain radiographs and computed tomography imaging. Patient demographics, injury and fracture patterns, methods and timing of fixation and clinical and radiological outcomes were assessed over a mean follow-up period of 7...
May 2015: Scottish Medical Journal
Kentaro Watanabe, Yoshitake Kino, Hiroki Yajima
To clarify the factors affecting functional results of fracture-dislocations of the proximal interphalangeal (PIP) joint treated by open reduction and internal fixation (ORIF), 60 patients, including 38 patients with a dorsal fracture-dislocation and 22 with a pilon fracture, were analysed. The mean ratio of articular surface involvement was 48.5% and a depressed central fragment existed in 75.3% of the cases. ORIF was performed in 47 patients through a lateral approach using Kirschner wires and in 13 through a palmar approach using a plate or screws...
2015: Hand Surgery
Yu Liang, Yue Fang, Chong-qi Tu, Xiang-yu Yao, Tian-fu Yang
OBJECTIVE: To study the related risk factors for surgical site infection following Pilon fracture surgery. METH ODS: The data of 561 patients with Pilon fractures treated with open reduction plate osteosynthesis at our institution's trauma centre were collected from January 2006 to December 2012. All the patients were divided into two groups: infection group and non-infection group. In the infection group, there were 23 males and 10 females, ranging in age from 21 to 69 years old, with an average of (45...
August 2014: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Yu Liang, Yue Fang, Chong-qi Tu, Xiang-yu Yao, Tian-fu Yang
OBJECTIVE: To study the related risk factors for surgical site infection following Pilon fracture surgery. METH ODS: The data of 561 patients with Pilon fractures treated with open reduction plate osteosynthesis at our institution's trauma centre were collected from January 2006 to December 2012. All the patients were divided into two groups: infection group and non-infection group. In the infection group, there were 23 males and 10 females, ranging in age from 21 to 69 years old, with an average of (45...
August 2014: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
F Lavini, C Dall'Oca, S Mezzari, T Maluta, E Luminari, F Perusi, E Vecchini, B Magnan
Fractures that involve the distal area of the tibia are associated with a high percentage of complications. Soft tissue oedema, swelling, blisters, skin abrasions and open wounds could compromise the outcome of these lesions. The waiting time before surgery with ORIF is mostly due to soft tissue conditions. Early application of a simple joint-spanning external fixator would achieve the initial goal of stability and the respect of soft tissue, thereby decreasing the time necessary for definitive treatment. A total of 40 consecutive patients (22 male and 18 female) with a mean age of 52 years (range 17-82 years) with distal tibial fracture treated between January 2010 and January 2013 were evaluated...
December 2014: Injury
Steven C Haase, Kevin C Chung
BACKGROUND: Proximal interphalangeal joint fracture-dislocations are common injuries that require expedient and attentive treatment for the best outcomes. Management can range from protective splinting and early mobilization to complex surgery. In this review, the current concepts surrounding the management of these injuries are reviewed. METHODS: A literature review was performed of all recent articles pertaining to proximal interphalangeal joint fracture-dislocation, with specific focus on middle phalangeal base fractures...
December 2014: Plastic and Reconstructive Surgery
Jonathan R Danoff, Comron Saifi, David C Goodspeed, J Spence Reid
INTRODUCTION: Open pilon fracture management and treatment poses a significant challenge to orthopedic surgeons. The purpose of this study was to determine patient outcomes for open pilon fractures based on wound complication and infection rates, as well as subjective outcome instruments. MATERIALS AND METHODS: This was a retrospective consecutive case series of 28 fractures with Orthopaedic Trauma Association (OTA)-type 43-B and 43-C open pilon fractures. Mean length of follow-up was 36 months and minimum of 1 year...
April 2015: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
A Martín Fuentes, E Sánchez Morata, M Mellado Romero, B Bravo Giménez, J Vilà y Rico
OBJECTIVE: To analyze the outcomes of distal tibia fractures with or without extension into the ankle joint, treated by percutaneous cannulated screws or locking plates. MATERIAL AND METHOD: A retrospective study was conducted on 107 patients treated between 2001 and 2012. INCLUSION CRITERIA: fractures 43-A and 43-C1 and C2 according to the AO/OTA system, treated with percutaneous osteosynthesis by locking plate or two cannulated screws in X -letter setting...
September 2014: Revista Española de Cirugía Ortopédica y Traumatología
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