The management of tibial pilon fractures with the Ilizarov fixator: The role of ankle arthroscopy

El-Mowafi, Hani; El-Hawary, Ahmed; Kandil, Yasser

doi:10.1016/j.foot.2015.08.004

Cited by 14 publications

(6 citation statements)

References 19 publications

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“…There is a high rate of infection and wound sloughing following open reduction and internal fixation of pilon fractures. The risk of arthrodesis or amputation has caused many surgeons to attempt reconstruction of the articular surface without exposing the fracture [ 7 , 8 ]. The use of the external fixator in treating pilon fractures allows restoration of length, stabilization of the limb, and correction of the mechanical axis.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of high-energy pilon fractures using the ILIZAROV treatment

Osman¹,

Alaya²,

Kaziz³

et al. 2017

Pan Afr Med J

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The management of high-energy pilon fractures is still controversial. Open reduction and internal fixation are often associated with serious complications. Various methods have been used to treat these injuries, with variable results. The aim of this retrospective study was to analyze the clinical and radiographic outcome of the ILIZAROV technique in patients with high-energy pilon fractures. Thirty cases of distal tibia epiphysis fractures (pilon fractures) were managed from 1999 to 2012. The study group included 5 cases of open fractures. The mean age was 47 years. According to Rüedi and Algower classification; 11 fractures were type II, and 19 type III. All fractures were a consequence of high-energy trauma. Fractures of the lower fibula were present in 28 of the patients. An external Fixator was applied for open fractures. Closed injuries were operated on 3 to 13 days after injury, with an average of 8 days. The mean follow-up was 48 months. All fractures united. The external fixator was removed after a mean of 22 weeks (10 - 28 weeks). Two patients with a type III fracture had a delayed union and were treated with corticotomy and dynamisation of the ILIZAROV fixator. Only one secondary displacement of a type III fracture was noted after two months and was treated by adjuction of 2 olive wires. There were no cases of osteomyelitis or deep infections. Pin-tract infections occurred in ten patients. We had not any case of nervous injury due to introduction of the pins. Using radiological criteria for assessement of reduction of the articular fragments, there was excellent and good restoration of articular structure in 24 cases. The average American Orthopeadic Foot and Ankle Society ankle-hind foot score was excellent in 16, good in 6, fair in 6 and poor in 2. Soft tissue healing occurred without need for plastic surgery in all cases. The movements of the ankle ranged from 0 to 20° of dorsiflexion and 5° to 40° of plantar flexion. Twenty patients had gone back to their preinjury profession. The ILIZAROV technique is a safe and a very effective treatment for severe pilon fractures with minimum complications and good healing results.

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Section: Discussionmentioning

confidence: 99%

“…The use of the external fixator in treating pilon fractures allows restoration of length, stabilization of the limb, and correction of the mechanical axis. In fact, with the external fixator used as a neutralization device, there is no need for large plates with the increased risk of infection and skin sloughing [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of high-energy pilon fractures using the ILIZAROV treatment

Osman¹,

Alaya²,

Kaziz³

et al. 2017

Pan Afr Med J

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“…This stage is flexible and all strategies offered for articular and extra-articular reduction can be used. For example, techniques that are useful for the articular and meta-diaphysis segments are by approving fracture fragments involving distal articular and adding metaphysical or metaphysical communication and adding to the minimum proximal [28].…”

Section: Open Reduction and Internal Fixationmentioning

confidence: 99%

A Current Concepts Update in Pilon Fracture Management

Utomo

Idulhaq

Abdulhamid

2022

Open Access Maced J Med Sci

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A review of the existing literature, related to treatment options and management principles of pilon fractures, was performed, and its results are presented. Pilon fractures have a very diverse pattern, but there are general characteristics to help diagnose and plan therapy. The choice of therapy is highly dependent on the surrounding soft-tissue environment. Different methods of treatment, lack of standard management protocols, and the high risk of complications make this injury one of the biggest challenges that an orthopedic surgeon can face. This review focuses on the general aspects of the pilon fracture management as well as its complications and possible solutions.

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“…Traditional clinical treatment for high-energy pilon fractures typically involves external fixation combined with limited internal fixation (10) and delayed open reduction and internal fixation (11)(12)(13). With advancements in instruments and the refinement of surgical techniques, arthroscopy is now also being utilized for the treatment of high-energy pilon fractures (14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Serum caspase‑1 levels serve as a predictive biomarker for the prognosis of patients undergoing arthroscopic‑assisted locking plate internal fixation in the treatment of high‑energy pilon fractures

Gao,

Liu,

Wang

et al. 2023

Exp Ther Med

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The present study aimed to investigate the serum levels of caspase-1 in patients with high-energy pilon fractures, and its correlation with prognosis and clinical results. In this prospective study, 136 patients with high-energy pilon fractures who were treated with a locking plate combined with ankle arthroscopy from July 2015 to July 2020 were included. The treatment efficacy was evaluated according to the Mazur ankle function score. Serum caspase-1, interleukin (IL)-6, IL-1β and C-reactive protein (CRP) levels were measured using enzyme-linked immunosorbent assay. Reverse transcription-quantitative PCR was used to measure the mRNA expression of caspase-1. Additionally, demographic data and clinical characteristics, such as sex, age, intraoperative blood loss, fracture healing time, fracture classification and complications were collected and analyzed. The study revealed that the intraoperative blood loss, proportion of Ruedi-Allgower III and the serum levels of caspase-1 in the poor prognosis group were significantly higher compared with those in the good prognosis group. Additionally, patients with high-energy pilon fractures in the poor prognosis group exhibited significantly higher levels of caspase-1 and IL-1β serum levels at all time points in contrast to those in the good prognosis group. Spearman's analysis revealed a significant association between caspase-1, IL-1β levels and Mazur scores. Furthermore, caspase-1 could serve as a potential diagnostic biomarker for poor prognosis of patients with high-energy pilon fractures. Caspase-1, IL-1β, intraoperative blood loss and Ruedi-Allgower grade were the risk factors for poor prognosis in patients with high-energy pilon fractures. In summary, this study demonstrated that serum caspase-1 levels were progressively reduced during the treatment of high-energy pilon fractures patients and prominently lowered in those with a favorable prognosis. These findings could provide novel targets and a comprehensive approach to protecting patients with high-energy pilon fractures.

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The management of tibial pilon fractures with the Ilizarov fixator: The role of ankle arthroscopy

Cited by 14 publications

References 19 publications

Treatment of high-energy pilon fractures using the ILIZAROV treatment

Treatment of high-energy pilon fractures using the ILIZAROV treatment

A Current Concepts Update in Pilon Fracture Management

Serum caspase‑1 levels serve as a predictive biomarker for the prognosis of patients undergoing arthroscopic‑assisted locking plate internal fixation in the treatment of high‑energy pilon fractures

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