High energy plafond fractures treated by a spanning external fixator initially and followed by a second stage open reduction internal fixation of the articular surface—preliminary report

Dickson, Kyle; Montgomery, Scott L.; Field, Justin

doi:10.1016/s0020-1383(01)00163-2

Cited by 69 publications

(35 citation statements)

References 21 publications

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“…For fractures with skin injury, important soft tissue oedema or delayed surgery, we recommend a two-staged protocol similar to that of many other authors [1,5,21]. The first stage consists of an approximate reduction and application of an external fixator spanning the ankle joint.…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…Conservative treatment of these fractures quite often results in number of complications including nonunion, malunion and ankle stiffness [11][12][13] . External fixation can be used as either a temporary or definitive method of treatment, especially in fractures with severe soft tissue injury [14][15][16][17][18] , but malunion and delayed union continue to be the main problems with this method [19,20] .…”

Section: Introductionmentioning

confidence: 99%

Outcome of distal tibia fractures treated with tibial linterlocking nail and minimal invasive plating: A prospective study

P¹,

Alwa²,

Patil³

et al. 2018

Int. J. Orthop. Sci.

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Introduction:The best modality of management of distal tibial fractures (extra articular) remains controversial and challenging. Various studies have shown varying results with different modalities of treatment, however our study is to compare functional and radiological outcomes between patients treated with tip locking nail and compression plate using MIPP0 Technique. The mechanism of injury and the prognosis of these fractures are different from pilon fractures, but their proximity to the ankle makes the surgical treatment more complicated than the tibial midshaft fractures. Material and methods: A total of 120 patients between the age of 25-50 years were treated randomly with nailing (Group A) and percutaneous plating (Group B) between the year May 2014-March 2017. At one year follow up, outcome was analysed based on union rate, operating time, complications (Infections, Nonunion, delayed union, malunion) and functional score by AOFAS (American orthopedic foot and ankle score). 53 patients included in group A and 55 patients in group B. 12 patients did not follow up. Result: Out of 108 patients randomly, average operating time in nailing is 44.21 mins and plating is 40.14 mins. 1 patient in group B developed superficial infection which healed well on long term follow up. In 30 patients, fibula fracture was first fixed using 3.5mm one third tubular plate and cortical screws due to ankle joint/syndesmotic instability. Mean radiological union time in nailing group was 20.1 weeks. (18-22 weeks) and plating group was 17.5 weeks (16-18 weeks). 4 cases in nailing developed malunion with angulation less than 5 degree which was acceptable and 2 cases developed varus deformity with angulation more than 5 degree. No cases of implant failure was noted. No evidence of nonunion was noted in both groups. Functional outcomes based on AOFAS score was IM nailing 90.8 and 96.2 for plating which was statistically significant between the 2 groups. In addition to pain which was included in AOFAS score 10 patients treated with IM nailing had anterior knee pain. Conclusion: Based on the above study, we concluded that treating distal tibia fractures (extraarticular) with locking compression plate using MIPPO technique is superior than tip locking nail as there is better anatomical reduction/alignment leading to quicker radiological union and better functional outcome according to AOFAS.

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“…To avoid the complications of external fixation Sirkin et al and Patterson & Cole popularized Staged management of these fractures [5,6] . Ankle spanning fixator may be used as the definitive method to stabilize the distal tibia [7,8,9] . The spanning fixator functions to neutralize the fracture, and the articular surface is reduced and internally fixed, either percutaneously or through limited open approaches or through more extensive open reduction.…”

Section: Introductionmentioning

confidence: 99%