Intraarticular ???Pilon??? Fracture of the Tibia

Helfet, David L.; Koval, Kenneth J.; Pappas, James J.; Sanders, Roy; DiPasquale, Thomas

doi:10.1097/00003086-199401000-00029

Cited by 127 publications

(93 citation statements)

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“…Helfet et al [26] demonstrated an impressive superficial infection rate of 3% and deep infection rate of 6% in their series of 32 high energy fractures treated with open reduction and internal fixation (26 cases) or external fixation (six cases). In all cases treatment was delayed until the soft tissues were deemed safe for intervention (average 7.3 days).…”

Section: Discussionmentioning

confidence: 97%

Complications of definitive open reduction and internal fixation of pilon fractures of the distal tibia

McCann

Jackson

Mitchell

et al. 2010

International Orthopaedics (SICOT)

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A series of 49 pilon fractures in a tertiary referral centre treated definitively by open reduction and internal fixation have been assessed and the complications of such injuries examined. A retrospective analysis of case notes, radiographs and computerised tomographs over a sevenyear period from 1999-2006 was performed. Infection was the most common postoperative problem. There were seven cases of superficial infection. There was a single case of deep infection requiring intravenous antibiotics and removal of metalwork. Other notable complications were those of secondary osteoarthritis (three cases) and malunion (one case). The key finding of this paper is the 2% incidence of deep infection following the direct operative approach to these fractures. The traditional operative approach to such injuries (initially advocated by Rüedi and Allgöwer in Injury 2:92-99, 1969) consisted of extensive soft tissue dissection to gain access to the distal tibia. Our preferred method is to access the tibia via the "direct approach" which involves direct access to the fracture site with minimal disturbance of the soft tissue envelope. We therefore believe that open reduction and internal fixation of pilon fractures via the direct approach to be a safe technique in the treatment of such devastating injuries.

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Section: Discussionmentioning

confidence: 97%

Complications of definitive open reduction and internal fixation of pilon fractures of the distal tibia

McCann

Jackson

Mitchell

et al. 2010

International Orthopaedics (SICOT)

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“…5,19e21 Helfet et al demonstrated a 5.9% deep infection rate in 34 patients undergoing primary ORIF. 22 More recently, White et al reported a 6% infection rate in primary ORIF of 99 pilons, but this included nearly 20% infection in those open fractures treated primarily. Our subset of patients who were treated with primary ORIF based on surgeon discretion with respect to the soft tissue readiness, had a deep infection rate of 7.8%, and included 127 fractures treated within 4 days of injury.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of deep infection in operatively treated pilon fractures (AO/OTA: 43)

Molina¹,

Stinner²,

Fras³

et al. 2015

Journal of Orthopaedics

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“…No significant difference between early and late surgical outcomes was found. [23][24][25][26] The most important factor that determines the timing of the surgery is the urgent operability of the fractures. For instance, in some cases, in order to prevent skin and wound problems, the patients are not operated within the first 8-12 hours, and the surgery should be postponed for 7-10 days.…”

Section: Discussionmentioning

confidence: 99%