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https://www.readbyqxmd.com/read/29158645/evaluation-of-functional-outcome-of-pilon-fractures-managed-with-limited-internal-fixation-and-external-fixation-a-prospective-clinical-study
#1
Umesh Kumar Meena, Mahesh Chand Bansal, Prateek Behera, Rahul Upadhyay, Gyan Chand Gothwal
Introduction: The management of pilon fractures is controversial primarily due to the high rate of complications irrespective of the mode of treatment. Limited internal fixation with external fixation is associated with minimal soft tissue handling. This may reduce the chances of wound dehiscence and infection. This study was designed to evaluate the functional and clinical outcomes in patients treated with limited internal fixation combined with external fixation in pilon fractures. Material and methods: This study was conducted as a prospective clinical study on 56 skeletally mature patients with closed fractures with poor skin condition, and with open grade 1 and grade 2 distal tibial intra-articular fractures...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158644/injury-mechanism-fracture-characteristics-and-clinical-treatment-of-pilon-fracture-with-intact-fibula-a-retrospective-study-of-23-pilon-fractures
#2
Jiang Liangjun, Zheng Qiang, Li Hang, Pan Zhijun
Objective: The effect of intact fibula on pilon fracture is not completely elucidated. We retrospectively analysed pilon fractures with intact fibula at our hospital over a 4 year period to understand the injury mechanism, fracture characteristics, treatment strategy and prognosis of this fracture. Methods: Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. OA/ATO fracture type, Ruedi-Allgower classification and fracture characteristics were summarised...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29126042/successful-treatment-of-infected-wound-dehiscence-after-minimally-invasive-locking-plate-osteosynthesis-of-tibial-pilon-and-calcaneal-fractures-by-plate-preservation-surgical-debridement-and-antibiotics
#3
Giandavide Ieropoli, Jorge Hugo Villafañe, Silvia Chiara Zompi, Umberto Morozzo, Riccardo D'Ambrosi, Federico Giuseppe Usuelli, Pedro Berjano
OBJECTIVE: The aim is to present a case series that illustrates possible benefits from combining minimally invasive plate osteosynthesis (MIPO), plastic surgery and antibiotic therapy, in order to treat and eradicate infection in patients with tibial pilon or calcaneal fractures. METHODS: Eleven consecutive patients with dehiscence of the surgical wound in outcomes MIPO using a Locking Compression Plate (LCP) for tibial pilon, or calcaneus fractures. The patients had developed a documented infection of the surgical wound...
October 23, 2017: Foot
https://www.readbyqxmd.com/read/29079366/quality-of-fracture-reduction-assessed-by-radiological-parameters-and-its-influence-on-functional-results-in-patients-with-pilon-fractures-a-prospective-multicentre-study
#4
Christoph Sommer, Sean E Nork, Matthew Graves, Michael Blauth, Mark Rudin, Karl Stoffel
INTRODUCTION: The management of pilon fractures remains a challenging issue. Due to the complexity of factors that influence the outcome, it has been questioned if anatomical reductions of articular fracture are relevant. The lack of a commonly accepted assessment of quality of fracture reduction compounded the uncertainty of the importance of anatomical reduction in pilon fracture. The current study aimed to define parameters that can better assess the reduction quality and to investigate the influence of reduction quality on functional outcomes...
October 20, 2017: Injury
https://www.readbyqxmd.com/read/29065036/is-it-safe-to-prep-the-external-fixator-in-situ-during-second-stage-pilon-surgical-treatment
#5
Paul J Nielsen, Leonid S Grossman, Justin C Siebler, Elizabeth R Lyden, Lori K Reed, Matthew A Mormino
OBJECTIVE: To evaluate the infection rate of our protocol of prepping the external fixator in situ during definitive second stage pilon fracture open reduction internal fixation. DESIGN: Retrospective clinical investigation. SETTING: Academic Level 1 Trauma Center. PATIENTS/PARTICIPANTS: Out of 229 patients with distal tibia fractures presenting to our institution from 1999-2014, 100 were treated in a two-stage fashion utilizing this protocol...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29062214/analysis-of-the-variables-affecting-outcome-in-fractures-of-the-tibial-pilon-treated-by-open-reduction-and-internal-fixation
#6
Rafael Carbonell-Escobar, Juan C Rubio-Suarez, Aitor Ibarzabal-Gil, E Carlos Rodriguez-Merchan
OBJECTIVE: To assess variables that could be related to outcomes in fractures of the tibial pilon treated by open reduction and internal fixation (ORIF). DESIGN: Retrospective. SETTING: University Hospital. PATIENTS: A total 92 fractures of the tibial pilon treated by ORIF in a 5-year period. The minimum follow-up was 1 year (mean: 3.3 years; range: 1-5). INTERVENTION: ORIF with LCP-LISS plate...
October 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29058951/stability-of-the-syndesmosis-after-posterior-malleolar-fracture-fixation
#7
Matthew A Miller, Tyler C McDonald, Matthew L Graves, Clay A Spitler, George V Russell, LaRita C Jones, William Replogle, Jeremy A Wise, Josie Hydrick, Patrick F Bergin
BACKGROUND: We sought to define the rate of syndesmotic instability after anatomic reduction of the posterior malleolus when posterior stabilization of a trimalleolar or trimalleolar equivalent ankle fracture was chosen vs when a supine position and initially conservative management of the posterior elements was chosen. METHODS: The types of syndesmotic and posterior malleolar fixation used to treat adult patients with ankle fractures involving the posterior malleolus at our level I trauma center were retrospectively assessed (N = 198)...
October 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28988807/increased-risk-for-complications-following-removal-of-hardware-in-patients-with-liver-disease-pilon-or-pelvic-fractures-a-regression-analysis
#8
Bryan D Brown, Justin N Steinert, John W Stelzer, Richard S Yoon, Joshua R Langford, Kenneth J Koval
PURPOSE: Indications for removing orthopedic hardware on an elective basis varies widely. Although viewed as a relatively benign procedure, there is a lack of data regarding overall complication rates after fracture fixation. The purpose of this study is to determine the overall short-term complication rate for elective removal of orthopedic hardware after fracture fixation and to identify associated risk factors. MATERIALS AND METHODS: Adult patients indicated for elective hardware removal after fracture fixation between July 2012 and July 2016 were screened for inclusion...
October 3, 2017: Injury
https://www.readbyqxmd.com/read/28986074/finite-element-analysis-of-the-stability-of-ao-ota-43-c1-type-distal-tibial-fractures-treated-with-distal-tibia-medial-anatomic-plate-versus-anterolateral-anatomic-plate
#9
O Fuad Oken, A Ozgur Yildirim, Mehmet Asilturk
BACKGROUND: The treatment of a pilon fracture type is possible from a medial, an anterolateral approach or both medial and lateral. The aim of study was compare the stability of two different plate fixation of a tibia pilon AO-43C1 type fractures. MATERIAL AND METHODS: In this study, three-dimensional finite element stress analysis was applied using isotropic materials and static linear analysis. Loading of 400 N force was applied to the model of a patient fixed in a standing position...
October 3, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28954524/impact-of-computed-tomography-on-operative-planning-for-ankle-fractures-involving-the-posterior-malleolus
#10
Steven Donohoe, R Kiran Alluri, J Ryan Hill, Mark Fleming, Eric Tan, Geoffrey Marecek
BACKGROUND: The purpose of this study was to (1) Determine the effect of computed tomography (CT) on identification of fractures involving the posterior malleolus, (2) determine its effect on operative indications, and (3) determine its effect on the overall operative plan. METHODS: Patients with ankle fractures involving the posterior malleolus were identified. Only injuries with complete preoperative plain radiographs and a CT scan were included. Spiral tibia fractures and pilon variants were excluded...
September 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28904724/treatment-of-high-energy-pilon-fractures-using-the-ilizarov-treatment
#11
Walid Osman, Zeineb Alaya, Hamdi Kaziz, Lassad Hassini, Meriem Braiki, Nader Naouar, Mohamed Laaziz Ben Ayeche
The management of high-energy pilon fractures is still controversial. Open reduction and internal fixation are often associated with serious complications. Various methods have been used to treat these injuries, with variable results. The aim of this retrospective study was to analyze the clinical and radiographic outcome of the ILIZAROV technique in patients with high-energy pilon fractures. Thirty cases of distal tibia epiphysis fractures (pilon fractures) were managed from 1999 to 2012. The study group included 5 cases of open fractures...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28826785/an-incidental-finding-of-a-talonavicular-and-talocalcaneal-joint-coalition-after-a-tibial-pilon-fracture-a-case-report
#12
Heidi M Godoy, Mark J Micciche
It has been proposed that patients with talocalcaneal and talonavicular coalitions have decreased ankle joint range of motion. It has also been reported that rotational forces regularly absorbed by the talocalcaneal joint are transferred to the ankle joint in patients with coalitions, increasing the stress on the ankle joint after trauma. To the best of our knowledge, only 1 reported study has detailed the increased stress placed on the ankle joint secondary to a coalition. We present a case study of a 53-year-old female who experienced a traumatic fall and subsequent right ankle fracture...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28798982/-pilon-fractures
#13
EDITORIAL
R Gaulke, T Mittlmeier
No abstract text is available yet for this article.
August 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28774706/pilon-fractures-a-new-classification-system-based-on-ct-scan
#14
Danilo Leonetti, Domenico Tigani
Actually, pilon fractures are classified according to AO and Ruedi Allgower classification systems based on X-rays. These classifications are less reproducible and do not provide necessary information for proper surgical planning. Aim of the study is to (1) propose a new classification system based on CT scan; (2) to check the prognostic value of this classification and (3) to evaluate its reliability and (4) reproducibility. We retrospectively reviewed 71 cases of pilon fracture. All fractures were classified according to AO, Ruedi Allgower and new proposed classification system by 5 surgeons...
October 2017: Injury
https://www.readbyqxmd.com/read/28767176/sequential-chimeric-medial-femoral-condyle-and-anterolateral-thigh-flow-through-flaps-for-one-stage-reconstructions-of-composite-bone-and-soft-tissue-defects-report-of-three-cases
#15
Dominic Henn, Mohamed H Abouarab, Christoph Hirche, Jochen F Hernekamp, Volker J Schmidt, Ulrich Kneser, Thomas Kremer
Small recalcitrant non-unions with poor perfusion require reconstruction with vascularized bone flaps. Cases with concomitant large soft tissue defects are especially challenging, since vascularized soft tissue transfer is often indicated and distant microvascular anastomoses may be required. We introduce a sequential chimeric free flap composed of a medial femoral condyle corticoperiosteal flap anastomosed to an anterolateral thigh flow-through flap (MFC-ALT flap) and report its use for reconstruction of small non-unions with concomitant large soft tissue defects in three exemplary patients...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28717978/-treatment-strategy-and-planning-for-pilon-fractures
#16
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
#17
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
#18
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
#19
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...
September 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
#20
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
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