Morbidities and prognostic factors after tibial pilon fracture: impact on patients

Hong, Choon Chiet; Tan, Si Heng Sharon; Saha, Soura; Pearce, Christopher J.

doi:10.1007/s00402-022-04456-8

Cited by 3 publications

(1 citation statement)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Historically, pilon fractures have high rates of morbidity and poor patient outcomes. [1][2][3][4] Anterolateral plating (ALP) of the distal tibia has gained popularity with the advent of new generations of precontoured implants designed to fit the anterolateral aspect of the distal tibia. These implants can be used to treat a wide range of distal tibia fractures, including OTA/AO 43A-C type fractures.…”

Section: Introductionmentioning

confidence: 99%

Anterior Tibial Artery Danger Zone During Anterolateral Plate Fixation of the Distal Tibia: A 3D CT Angiogram Modeling Study

O’Leary,

Mitchell,

Thomas

et al. 2023

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

Objectives: The objective of this study was to define the danger zone at which the anterior tibial artery (ATA) is at risk during anterolateral plating of the distal tibia using a novel 3D CTA modeling technique. Methods: We identified 116 patients (232 lower extremities) with lower extremity CTAs performed between 04/2020 and 04/2022. Those with lower extremity trauma, evidence of a previously healed tibia fracture, or poor visualization of the ATA were excluded. The remaining 150 lower extremities (92 patients) were modeled with an anterolateral distal tibia plate using Sectra IDS7 software. The distance of the ATA from bony landmarks was measured perpendicular to the level at which the vessel intersected the plate. Results: The ATA intersected the plate at a mean distance of 10.5 cm (95% CI 10.2 – 10.9) proximally, and distally at a mean distance of 4.6 cm (95% CI 4.4 – 4.9) from the central tibial plafond. The ATA intersected with the plate as far distal as hole number 1 and as proximal as hole 14 of the plate. The greatest injury risk was associated with plate holes 3-8. In this region the artery was at risk in 46-99 percent of specimens. Conclusions: The ATA is at risk when percutaneously placing screws in an anterolateral distal tibia plate. The artery can be as close as 4.4 cm and as far as 10.9 cm proximal to the tibial plafond when crossing the plate, correlating to a risk of injury to the ATA at plate holes 1 through 14. Level of Evidence: Level IV, computed tomography angiography study.

show abstract

Section: Introductionmentioning

confidence: 99%