Clinical application of arthroscopy-assisted minimally invasive therapy in Chinese elderly with type III Pilon fracture

Liu, Peiming; Guo, Yong Cheng; Wen, Ying; Wang, Wei

doi:10.2147/cia.s140272

Cited by 3 publications

(13 citation statements)

References 26 publications

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“…The RCT utilized the Ruedi-Allgower system (all patients with type III pilon fractures), whereas the case series used the AO/OTA classification (AO 43-C1 pilon fracture). 25,26 In the RCT study, patients were split evenly into 2 groups with no difference in age, sex, mechanism, side, and type of fracture ( P > .05 for all); 115 patients (group A) underwent external fixation combined with limited internal fixation (EFLIF), whereas the other 115 patients (group B) underwent AAORIF. 25 The patients in the case series underwent arthroscopy-assisted reduction with limited internal fixation combined with external fixation (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The relatively equal and lower rates for each complication, respectively, support the conclusion that the complications were unlikely attributable to AAORIF. 25 No complications were reported with the case series.…”

Section: Pilon Fracturesmentioning

confidence: 89%

“…Although AAORIF of foot and ankle fractures has been described for roughly 30 years, newer techniques such as Park et al's modified arthroscopic open reduction internal fixation sinus tarsi approach (AORIF-STA) procedure for calcaneal fractures or Liu et al's arthroscopy-assisted minimally invasive approach to pilon fractures, continue to emerge. 25,29 Interestingly, Park et al found that the mean operative time for the AORIF-STA group was shorter than for the ORIF group, though not statistically significant. 29 This may reflect more efficient achievement of anatomic reduction compared with the open group, which may require obtaining multiple fluoroscopic views for assessing the quality of reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Review of current literature identified 2 studies, 1 nonblinded randomized controlled trial (RCT) and 1 case series, that met criteria for this review. 25,26 The total number of patients from these studies was 243. There were 166 men and 77 women with ages ranging from 19 to 68 years old.…”

Section: Pilon Fracturesmentioning

confidence: 99%

“…Mean follow-up time among studies was 12 months. 25,26 Study results. Both studies used the Mazur Ankle Grading Scale.…”

Section: Pilon Fracturesmentioning

confidence: 99%

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Arthroscopically Assisted Internal Fixation of Foot and Ankle Fractures: A Systematic Review

Williams

Joo

et al. 2021

Foot & Ankle Orthopaedics

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Background: Patients undergoing fixation for foot and ankle fractures may experience poor outcomes despite achieving apparent anatomic reduction. Adjunct arthroscopy to identify missed concomitant injuries and subtle displacements has been proposed as a vehicle to enhance functional results for these patients. The purpose of this review is to provide an overview of the literature regarding arthroscopically assisted open reduction and internal fixation (AAORIF) methods for commonly encountered foot and ankle injuries including pilon, ankle, and calcaneus fractures published to date. Methods: A systematic review of the literature was performed using the PubMed database to access all studies reporting on arthroscopically assisted internal fixation methods for pilon, ankle, and calcaneus fractures. Relevant publications were analyzed for details on their respective study designs, the operative technique used, clinical outcomes, outcome instruments used, and reported complications. Results: A total of 32 studies were included in this review. Two studies on pilon fractures, a randomized controlled trial (RCT) and case series with a total of 243 patients, met inclusion criteria. Postoperative articular reductions, bone union, and Mazur scores were found to be significantly better for those using adjunct arthroscopy when compared to those with no arthroscopy use. Patient-reported outcomes were overall reported as excellent for most patients, with no difference in patient-reported outcomes reported in the RCT. For ankle fractures, a total of 17 studies comprising of 2 systematic reviews, 1 meta-analysis, 2 RCTs, 5 retrospective comparative studies, 6 case series, and 1 case-control study met inclusion criteria for this review. Results were mixed, though the overall consensus was that arthroscopy use may help to better visualize concomitant intra-articular injuries and is generally considered safe with at least comparable outcomes to conventional methods. For the calcaneus, 13 studies met the criteria. Two studies were review papers, 8 were case series, and 3 were retrospective comparative studies. A total of 308 patients with 316 fractures formed the basis of analysis. In general, the studies found comparable functional outcomes between with or without arthroscopy use, but found that anatomical reductions were significantly improved with the use of arthroscopy. Conclusions: Arthroscopy shows promise as a valuable adjunct tool for internal fixation of foot and ankle fractures, though definitive conclusions as to its clinical significance have yet to be drawn because of limited evidence. Potential advantages related to the direct visualization of the fracture site and minimally invasive nature of arthroscopy were suggested throughout studies examined in this review. The presence of intra-articular pathology may lead to unexpectedly poor outcomes seen in some patients who undergo surgical fixation of ankle fractures with an otherwise anatomic reduction on postoperative radiographs; the ability to diagnose and address these lesions with arthroscopy, therefore, has the potential to improve patient outcomes. To date, however, available literature has not shown that significant improvements in anatomical reductions and treatment of these intra-articular injuries provide any improvement in outcomes over standard fixation methods. Few prospective randomized controlled studies have been performed comparing these 2 operative techniques, rendering any suggestion that AAORIF improves clinical outcomes over traditional open fixation difficult to justify. Further research is indicated for what may be a potentially promising surgical adjunct prior to advocating for its routine use in patients.

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Section: Resultsmentioning

confidence: 99%

Section: Pilon Fracturesmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Pilon Fracturesmentioning

confidence: 99%

“…Mean follow-up time among studies was 12 months. 25,26 Study results. Both studies used the Mazur Ankle Grading Scale.…”

Section: Pilon Fracturesmentioning

confidence: 99%

See 3 more Smart Citations

Arthroscopically Assisted Internal Fixation of Foot and Ankle Fractures: A Systematic Review

Williams

Joo

et al. 2021

Foot & Ankle Orthopaedics

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Percutaneous Arthroscopic Assisted Fixation of a Tibial Plafond Impaction Fracture Fixation: Surgical Technique and Case Report

Newman¹,

Goriainov²,

Marsland³

2021

Techniques in Foot &Amp; Ankle Surgery

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Tibial plafond fractures are high energy injuries caused by axial loading. Despite evolving equipment and surgical techniques, the prognosis remains relatively poor for individuals who sustain this type of injury, with reduced functional outcomes and early posttraumatic osteoarthritis. We present a case of a tibial plafond fracture treated percutaneously with arthroscopic assisted reduction, bone grafting and fixation, without the requirement for an external fixator, and with a successful outcome at 1-year follow up.

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Role of Arthroscopy in Pilon Fractures: How and When do I do It?

Slocum,

Lui

2024

Journal of Foot and Ankle Surgery (Asia Pacific)

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Clinical application of arthroscopy-assisted minimally invasive therapy in Chinese elderly with type III Pilon fracture

Cited by 3 publications

References 26 publications

Arthroscopically Assisted Internal Fixation of Foot and Ankle Fractures: A Systematic Review

Arthroscopically Assisted Internal Fixation of Foot and Ankle Fractures: A Systematic Review

Percutaneous Arthroscopic Assisted Fixation of a Tibial Plafond Impaction Fracture Fixation: Surgical Technique and Case Report

Role of Arthroscopy in Pilon Fractures: How and When do I do It?

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