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pilon tibial fractures

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
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 to 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...
October 1, 2016: Journal of Orthopaedic Trauma
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
Shao-hua Jia, Cheng-long Huang, Hong-wei Xu, Sui-liang Gong
OBJECTIVE: To explore clinical results of open reduction and internal fixation (ORIF) for posterior Pilon fracture through posterolateral approach. METHODS: Seventeen patients with posterior Pilon fracture were treated through posterolateral approach from February 2010 to April 2013. Among them,including 11 males and 6 females aged from 29 to 59 with an average of 43.4 years old. All fractures were associated with more than 20% of articular surface of distal tibial...
June 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Vito N Galante, Giovanni Vicenti, Gianfranco Corina, Claudio Mori, Antonella Abate, Girolamo Picca, Vito Conserva, Domenico Speciale, Lorenzo Scialpi, Nicola Tartaglia, Vincenzo Caiaffa, Biagio Moretti
OBJECTIVES: To determine the efficacy of hybrid external fixation in the treatment of tibial pilon fractures. DESIGN: Retrospective, multicentre study. PATIENTS/PARTICIPANTS: Adult patients with tibial pilon fractures treated with hybrid external fixation. INTERVENTION: Fracture reduction with ligamentotaxis and fixation with XCaliber hybrid external fixator. MAIN OUTCOME MEASUREMENTS: Fracture union, complications, functional outcome (Mazur Ankle Score)...
July 30, 2016: Injury
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...
July 7, 2016: Injury
Lindsay E Hickerson, Diederik O Verbeek, Craig E Klinger, David L Helfet
This video reviews the indications, surgical approach, and case examples of the anterolateral approach to a distal tibial plafond fracture. If this approach is used in a staged fashion, when the soft envelope is ready, it affords excellent visualization for fracture fixation through thick skin flaps. An associated article reviews a cohort of 44 mainly type C3 pilon injuries treated by 2 orthopaedic traumatologist using the anterolateral approach after staged external fixation. An anatomic or good fracture reduction was obtained in 41 fractures with 13...
August 2016: Journal of Orthopaedic Trauma
Kevin Dibbern, Laurence B Kempton, Thomas F Higgins, Saam Morshed, Todd O McKinley, J Lawrence Marsh, Donald D Anderson
Patients with tibial pilon fractures have a higher incidence of post-traumatic osteoarthritis than those with fractures of the tibial plateau. This may indicate that pilon fractures present a greater mechanical insult to the joint than do plateau fractures. We tested the hypothesis that fracture energy and articular fracture edge length, two independent indicators of severity, are higher in pilon than plateau fractures. We also evaluated if clinical fracture classification systems accurately reflect severity...
July 6, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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) role as pillar for data-driven management of extremity war wounds. 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 orthopaedic specific information towards the question of causes for late amputation...
May 27, 2016: Journal of Trauma and Acute Care Surgery
Walter Daghino, Marco Messina, Marco Filipponi, Massè Alessandro
BACKGROUND: The tibial pilon fractures represent a complex therapeutic problem for the orthopedic surgeon, given the frequent complications and outcomes disabling. The recent medical literature indicates that the best strategy to reduce amount of complications in tibial pilon fractures is two-stages procedure. We describe our experience in the primary stabilization of these fractures. METHODS: We treated 36 cases with temporary external fixation in a simple configuration, called "tripolar": this is an essential structure (only three screws and three rods), that is possible to perform even without the availability of X-rays and with simple anesthesia or sedation...
2016: Open Orthopaedics Journal
Jonathan Tresley, Ty K Subhawong, Adam D Singer, Paul D Clifford
OBJECTIVE: To examine the association between tibial pilon and calcaneal fracture classification and tendon entrapment or dislocation. MATERIALS AND METHODS: After institutional review board approval, we retrospectively reviewed consecutive CT scans with calcaneal or pilon fractures from 5 years at a level 1 trauma center. We categorized calcaneal fractures according to the Sanders classification, and pilon fractures according to the Ruedi and Allgower and the Arbeitsgemeinschaft für Osteosynthesefragen-Orthopaedic Trauma Association (AO-OTA) classifications...
July 2016: Skeletal Radiology
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
Stefan Rammelt, Hans Zwipp
Malunions of the tibial pilon lead to painful posttraumatic ankle arthritis and malposition of the hindfoot with severe functional disability. Most will need corrective ankle fusion as a salvage procedure. Joint-preserving correction with secondary anatomic reconstruction for intra-articular malunions is possible only in carefully selected patients with intact cartilage, sufficient bone quality, residual function, and good compliance. Osteotomies of solid malunions are planned according to preoperative computed tomography scans...
March 2016: Foot and Ankle Clinics
Christopher Allmon, Patrick Greenwell, Ebrahim Paryavi, Andrew Dubina, Robert V OʼToole
OBJECTIVES: Compartment syndrome (CS) is a potentially devastating injury associated with tibial fractures. Few data exist regarding radiographic indicators of CS. We hypothesized that radiographic signs are associated with development of CS. DESIGN: Retrospective review. SETTING: Level I trauma center. PATIENTS: Consecutive series of adult patients with tibial fractures with (n = 56) and without (n = 922) CS. INTERVENTION: None...
July 2016: Journal of Orthopaedic Trauma
Arjun Ballal, H Ravindranath Rai, Siddharth M Shetty, Lawrence John Mathias, Vikram Shetty, Ashwin Shetty
INTRODUCTION: Managing pilon fractures is still a great challenge for surgeons in terms of reduction and fixation. The soft tissue anatomy and the bony configuration, results in angular and rotational instability and other bony and soft tissue complications. AIM: To evaluate the results of minimally invasive plate osteosynthesis using locking plates in management of fractures of tibial pilon in terms of radiological fracture union, restoration of ankle function and complications...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
Dinko Vidović, Aljoša Matejčić, Mihovil Ivica, Darko Jurišić, Esmat Elabjer, Bore Bakota
INTRODUCTION: Distal tibial or pilon fractures are usually the result of combined compressive and shear forces, and may result in instability of the metaphysis, with or without articular depression, and injury to the soft tissue. The complexity of injury, lack of muscle cover and poor vascularity make these fractures difficult to treat. Surgical treatment of distal tibial fractures includes several options: external fixation, IM nailing, ORIF and minimally-invasive plate osteosynthesis (MIPO)...
November 2015: Injury
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
Nebu Jacob, Amit Amin, Nikolaos Giotakis, Badri Narayan, Selvadurai Nayagam, Alex J Trompeter
Tibial pilon fractures result from high-energy trauma unlike usual ankle fractures. Their management provides numerous challenges to the orthopaedic surgeon including obtaining anatomic reduction of articular surface and the management of associated soft tissue injuries. This article aims to review major advances and principles that guide our practice today. We also discuss a treatment algorithm based on a staged approach to the fracture: initial spanning external fixation followed by definitive fixation.
November 2015: Strategies in Trauma and Limb Reconstruction
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
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