Surgical Management of Distal Tibia Fracture: Towards An Outcome-based Treatment Algorithm

Rushdi, I; Che-Ahmad, Aminudin; Abdul-Ghani, Kah; Mohd-Rus, R

doi:10.5704/moj.2011.010

Cited by 5 publications

(5 citation statements)

References 22 publications

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“… 1 Furthermore, 20% to 40% of these fractures are open. 2 Pilon fractures are more common in the fourth decade of life and in male subjects .3 They often result from high-energy trauma with axial load and shear force, 4 such as in falls and traffic accidents. 5 These fractures can also occur due to rotational trauma, such as in injuries due to sporting activities.…”

Section: Introductionmentioning

confidence: 99%

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Uso da impressão tridimensional para auxílio diagnóstico e terapêutico das fraturas de pilão tibial

Wustro,

Silva,

Moura

et al. 2024

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Avaliar se a impressão tridimensional (3D) aumenta a concordância na classificação de fraturas do pilão tibial. Métodos Foram selecionadas radiografias, tomografias com reconstrução 3D e impressão de prototipagem em impressora 3D. Os exames foram apresentados a profissionais da área de Ortopedia e Traumatologia que classificaram as fraturas com base nas classificações da Arbeitsgemeinschaft für Osteosynthesefragen (AO, Associação para o Estudo da Fixação Interna) Foundation/Orthopedic Trauma Association (AO/OTA) e de Rüedi-Allgöwer. Posteriormente, os dados foram avaliados pelos coeficientes de concordância de Kappa. Resultados O uso do modelo 3D não melhorou a concordância na fratura do pilão tibial quanto ao tratamento proposto pelos grupos. Em relação aos sistemas de classificação, somente a concordância na classificação AO/OTA melhorou quando foi utilizado o modelo 3D na avaliação pelos especialistas em pé e tornozelo. Conclusão Apesar de o uso da impressão 3D ter relevância estatística para os cirurgiões especialistas em pé e tornozelo, ainda apresenta valores menores do que os ideais.

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Section: Introductionmentioning

confidence: 99%

“… 1 Além disso, 20% a 40% das fraturas são expostas. 2 É mais comum na quarta década de vida e em homens. 3 Ela geralmente ocorre como resultado de um trauma de alta energia com carga axial e força de cisalhamento, 4 como em quedas e em acidentes automobilísticos.…”

Section: Introductionunclassified

Uso da impressão tridimensional para auxílio diagnóstico e terapêutico das fraturas de pilão tibial

Wustro,

Silva,

Moura

et al. 2024

Rev Bras Ortop (Sao Paulo)

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“…It is a break in the lower part of the shinbone that includes the metaphyseal region and can potentially extend to the weight-bearing joint surface. It is also referred to as a tibial pilon fracture or tibial plafond fracture when the joint surface is involved [2]. Intra-articular fractures occurring at the distal end of the tibia, which involve a substantial portion of the weight-bearing articular surface, present formidable Medicina 2023, 59, 1751 2 of 11 complexities and difficulties in their therapeutic management [3].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap

Lee,

Yang

et al. 2023

Medicina

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Introduction: Distal tibial fractures make up approximately 3% to 10% of all tibial fractures or about 1% of lower extremity fractures. MIPO is an appropriate procedure and method to achieve stable metal plate fixation and osseointegration by minimizing soft tissue damage and vascular integrity at the fracture site. MIPO to the medial tibia during distal tibial fractures induces skin irritation due to the thickness of the metal plate, which causes discomfort and pain on the medial side of the distal leg, and if severe, complications such as infection and skin defect may occur. The reverse sural flap is a well-researched approach for covering defects in the lower third of the leg, ankle, and foot. Materials and Methods: Among 151 patients with distal tibia fractures who underwent minimally invasive metal plate fixation, soft tissue was injured due to postoperative complications. We treated 13 cases with necrosis and exposed metal plates by retrograde nasogastric artery flap surgery. For these patients, we collected obligatory patient records, radiological data, and wound photographs of the treatment results and complications of reconstructive surgery. Results: In all the cases, flap survival was confirmed at the final outpatient follow-up. The exposed area of the metal plate was well coated, and there was no plate failure due to complete necrosis. Three out of four women complained of aesthetic dissatisfaction because the volume of the tunnel through which the skin mirror passed and the skin plate itself were thick. In two cases, defatting was performed to reduce the thickness of the plate while removing the metal plate. Conclusions: Metal plate exposure after distal tibial fractures have been treated with minimally invasive metal plate fusion and can be successfully treated with retrograde nasogastric artery flaps, and several surgical techniques are used during flap surgery.

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confidence: 99%

“…Distal tibial pilon fractures are stabilized by open reduction and internal fixation, closed/open reduction and Ilizarov circular external fixation, or staged with initial temporary external fixation/skeletal traction, followed by definitive internal/circular external fixation 1 . The treatment is based on the extent of soft-tissue damage 1 . A meta-analysis, which included 5 studies and 281 fractures involving the tibial pilon, of which 117 patients underwent circular external fixation and 164 patients underwent open reduction and internal fixation, concluded that both were similar in functional outcome and postoperative complications such as nonunion, malunion, and deep infection 2 .…”

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Irreducible Tibial Pilon Fracture Treated with Single-Stage Closed Ilizarov Fixation and Gradual Correction

Gopalan

2023

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Case:A young polytrauma victim of a road traffic accident was diagnosed with comminuted articular fracture of the left distal tibial pilon and open segmental fracture of the fibula. The comminuted distal tibial metaphysis was translocated into the interosseous space and, hence, was irreducible. He underwent single-stage closed Ilizarov device stabilization and gradual postoperative closed reduction to obtain good functional outcome at 9 months. The lung and scapular injuries were treated conservatively.Conclusion:Acute complex irreducible tibial pilon fracture can be treated according to principles of deformity correction with the Ilizarov device.

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Surgical Management of Distal Tibia Fracture: Towards An Outcome-based Treatment Algorithm

Cited by 5 publications

References 22 publications

Uso da impressão tridimensional para auxílio diagnóstico e terapêutico das fraturas de pilão tibial

Uso da impressão tridimensional para auxílio diagnóstico e terapêutico das fraturas de pilão tibial

Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap

Irreducible Tibial Pilon Fracture Treated with Single-Stage Closed Ilizarov Fixation and Gradual Correction

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