Complications Encountered in the Treatment of Pilon Fractures

Mcferran, Mark A.; Smith, Stephen T.; Boulas, H. Jay; Schwartz, Herbert S.

doi:10.1097/00005131-199206000-00011

Cited by 336 publications

(209 citation statements)

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“…Despite progress of surgical procedures, outcomes are not always excellent and complications affect 20-50% of patients [2,11,12]. The purpose of this paper was to study the functional and radiographic outcomes after distal tibia fractures, to evaluate complications and to determine predictive factors of poor results.…”

Section: Introductionmentioning

confidence: 99%

Distal tibia fractures: management and complications of 101 cases

Joveniaux

Ohl

Harisboure

et al. 2009

International Orthopaedics (SICOT)

148

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Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12-46). Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. The average functional score was 76 points (range, 30-100 points), and complications occurred in 30 patients. Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol. For other cases, we recommend ORIF with early mobilisation.

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Section: Introductionmentioning

confidence: 99%

Distal tibia fractures: management and complications of 101 cases

Joveniaux

Ohl

Harisboure

et al. 2009

International Orthopaedics (SICOT)

148

View full text Add to dashboard Cite

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“…Treatment of these fractures, both operative and non-operative, can have high complication rates, reportedly between 27% and 54% [5,13,14,2,27]; high rates of revision surgery, reportedly from 10% to 23% [5,10,12]; and significant residual dysfunction [1,12,18]. Some of these problems are almost certainly related to damage to the overlying articular cartilage, which inevitably sustains additional injuries during the initial event.…”

Section: Discussionmentioning

confidence: 99%

Does the relative density of periarticular bone influence the failure pattern of intra-articular fractures?

Tetsworth

Borshch

Dlaska

et al. 2016

Injury

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“…Early morbidity of these injuries tends to be related to the extent of the soft tissue injury and potential for subsequent infection. With historical rates of infection after early definitive fixation for these injuries approaching 50% in some series, a staged protocol with early external fixation followed by delayed definitive internal fixation has been widely adopted [7,13,16]. Despite this treatment algorithm, wound complications persist, and deep infection rates are reported to be between 5% and 24% [2,[4][5][6]12].…”

Section: Introductionmentioning

confidence: 99%

Does Early versus Delayed Spanning External Fixation Impact Complication Rates for High-energy Tibial Plateau and Plafond Fractures?

Haller

Holt

Rothberg

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background High-energy tibial plateau and tibial plafond fractures have a high complication rate and are frequently treated with a staged approach of spanning external fixation followed by definitive internal fixation after resolution of soft tissue swelling. A theoretical advantage to early spanning external fixation is that earlier fracture stabilization could prevent further soft tissue damage and potentially reduce the occurrence of subsequent infection. However, the relative urgency of applying the external fixator after injury is unknown, and whether delay in this intervention is correlated to subsequent treatment complications has not been examined. Questions/purposes Is delay of more than 12 hours to spanning external fixation of high-energy tibial plateau and plafond fractures associated with increased (1) infection risk; (2) compartment syndrome risk; and (3) time to definitive fixation, length of hospitalization, or risk of secondary surgeries? We further stratified our results based on injury site: plateau and plafond. In practical clinical terms, many of these high-energy C-type articular fractures will arrive at the regional trauma center in the evening and this investigation attempted to explore if these injuries need to be placed in temporizing fixators that evening or if they may be safely addressed in a dedicated trauma room the next morning. Methods We performed a retrospective review of all patients at a Level I university trauma center with highenergy tibial plateau and plafond fractures who underwent staged treatment with a spanning external fixation followed by subsequent definitive internal fixation between 2006 and 2012. Patients who received a fixator within 12 hours of recorded injury time were classified as early external fixation; those who received a fixator greater than 12 hours from injury were classified as delayed external fixation. There were 80 patients (42 plateaus and 38 plafonds) in the early external fixation cohort and 79 patients (45 plateaus and 34 plafonds) in the delayed external fixation cohort. Deep infection rate was 13% in plateau fractures and 18% in plafond fractures. Rates of infection, compartment One of the authors (ENK) has received research support funding from the Department of Defense Congressionally Directed Medical Research Program and VA Early Feasibility Program. One of the authors (TFH) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: DePuy Synthes (West Chester, PA, USA) in the amount of less than USD 10,000. One of the authors (ENK) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: CoNextions (Sandy, UT, USA) in the amount of more than USD 10,000, OrthoGrid (Salt Lake City...

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Complications Encountered in the Treatment of Pilon Fractures

Cited by 336 publications

References 0 publications

Distal tibia fractures: management and complications of 101 cases

Distal tibia fractures: management and complications of 101 cases

Does the relative density of periarticular bone influence the failure pattern of intra-articular fractures?

Does Early versus Delayed Spanning External Fixation Impact Complication Rates for High-energy Tibial Plateau and Plafond Fractures?

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