Stability and quality of osteosynthesis in treatment of tibial pylon fractures with dynamic external fixation typ Mitkovic

Bozovic, Aleksandar; Mb, Mitkovic; Grbić, R; Vasić, A.; Jaksic, Ljubomir; Petrović, Dušan; Radojevic, Goran; D, Milović; Adzić,

doi:10.2298/aci1302093b

Cited by 2 publications

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“…Tibial pilon fractures are severe injuries with high complication rates with the range of 11.4–54% [6,12] . The risk is related to the mechanism of injury, although it can also be attributed to the preferred the surgical technique.…”

Section: Discussionmentioning

confidence: 99%

“…Wound site problems and infections constitute major surgical issues, especially in patient series treated with internal fixation, and rates as high as 67% have been reported [14–16] . Developments in low-profile internal fixator technology and external fixation techniques may be able to decrease this rate to 10% [12–17] . Pin bottom infection was observed in 8 patients in our study group following treatment with mini open reduction and hybrid external fixation.…”

Section: Discussionmentioning

confidence: 99%

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Hybrid external fixation via a minimally invasive method for tibial pilon fractures - Technical note

Bülbül

Kuyucu

Say

et al. 2015

Annals of Medicine &Amp; Surgery

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IntroductionWe aimed to present the clinical and radiological outcomes of patients with tibial pilon fractures who were treated with hybrid external fixators. Shanz screws were applied synchronously and used as joysticks for fracture reduction. Radiological evaluations were conducted on roentgenograms at the second week, sixth week, third month and first year.Material and methodsThe study group included 42 patients with tibial pilon fractures that were classified as 43C according to the AO/OTA classification system. We used 2-hydroxyapatite-coated Schanz screws for the tibial pilon reduction. Schanz screws fixated to two separate motors were synchronously passed through the fracture fragments. An external fixator was applied after the fracture was stabilized with Schanz screws.Results and discussionThe mean operation duration was 45 min Fracture healing was observed in all patients, and the mean fracture healing time was 17 (range, 12–32 weeks) weeks. The mean lateral distal tibial angle was 89°. Joint surface irregularity was not observed in any patient. All of the patients had 0–15° of ankle dorsiflexion. None of the patients had restricted ankle plantar flexion. No wound complications were observed. According to the AOFAS scoring system, the clinical evaluation was excellent in 26 patients, good in 14 patients and fair in 2 patients. Malunion and nonunion may necessitate additional surgical procedures, delay the return to activities of daily living, and increase treatment costs. Good alignment was achieved, with a mean lateral distal tibial angle of 89 (range, 84–92) degrees.ConclusionPermanent hybrid external fixator applied using Schanz screws via a mini open technique is a fast, easily applied alternative with low morbidity and satisfying results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hybrid external fixation via a minimally invasive method for tibial pilon fractures - Technical note

Bülbül

Kuyucu

Say

et al. 2015

Annals of Medicine &Amp; Surgery

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Treatment of open extruded fracture neck of the talus using the combined method of external fixation modified for dynamic ankle joint fixation and Kirschner wires

Božović,

Lalić,

Petrović

et al. 2024

Sanamed

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Introduction: Open extruded fractures of the talus occur in 2% of talar fractures. These fractures are challenging for surgeons due to complications such as infection, nonunion, and arthritis. The most common treatment method is talus reimplantation and osteosynthesis. Case report: A 19-year-old presented with an open extruded fracture of the talus, classified as Hawkins II, following a fall from a height. Emergency surgery involved wound debridement, talus reimplantation, osteosynthesis with modified external fixation for dynamic ankle joint fixation (Mitkovic-type), and two Kirschner wires. Fragments were repositioned under C-Arm fluoroscopy. The patient received a 14-day antibiotic regimen (Cephalosporins, Aminoglycoside, Metronidazole) and thromboembolic prophylaxis for 35 days. After 6 weeks we allowed movements in the ankle joint with physical therapy. Gradual weight-bearing was allowed after 8 weeks. The osteosynthetic material was removed after 18 weeks, with full weight-bearing achieved after 6 months. Radiographic follow-up was conducted up to 24 months postoperatively, showing excellent healing with minimal dorsiflexion restriction. Conclusions: Treating this injury is a significant challenge. External fixation can be a viable method for managing open luxation fractures of the talus.

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Stability and quality of osteosynthesis in treatment of tibial pylon fractures with dynamic external fixation typ Mitkovic

Cited by 2 publications

References 2 publications

Hybrid external fixation via a minimally invasive method for tibial pilon fractures - Technical note

Hybrid external fixation via a minimally invasive method for tibial pilon fractures - Technical note

Treatment of open extruded fracture neck of the talus using the combined method of external fixation modified for dynamic ankle joint fixation and Kirschner wires

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