The Treatment of Pilon Fractures

Sirkin, Michael; Sanders, Roy

doi:10.1016/s0030-5898(05)70196-6

Cited by 72 publications

(60 citation statements)

References 29 publications

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“…Similar to many other authors, we found that definitive external fixation provided more malunion, stiffness or pain than ORIF [6,8,10]. Thus, we believe that external fixation should be preferentially used in two-staged protocols as a temporary device before ORIF or limited internal fixation [1,5]. Our ipsilateral fibular fracture rate was small in comparison to rates near 80% found in the literature [17,18].…”

Section: Discussionsupporting

confidence: 88%

“…Based on our study, when using external fixation, the complication rate is higher and functional outcomes are worse. We believe that external fixation must be reserved for trauma with severe skin injury as a temporary solution in a two-staged protocol as described by Sirkin et al [1]. For other cases, we recommend ORIF with early mobilisation.…”

Section: Resultsmentioning

confidence: 98%

“…For fractures with skin injury, important soft tissue oedema or delayed surgery, we recommend a two-staged protocol similar to that of many other authors [1,5,21]. The first stage consists of an approximate reduction and application of an external fixator spanning the ankle joint.…”

Section: Discussionmentioning

confidence: 99%

“…Management of distal tibia fractures, with or without articular involvement, is a therapeutic challenge [1][2][3][4]. The goal of orthopaedic surgeons is to restore the tibial anatomy, to fix the epi-metaphyseal block with the diaphysis and to avoid complications.…”

Section: Introductionmentioning

confidence: 99%

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Distal tibia fractures: management and complications of 101 cases

Joveniaux

Ohl

Harisboure

et al. 2009

International Orthopaedics (SICOT)

148

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Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12-46). Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. The average functional score was 76 points (range, 30-100 points), and complications occurred in 30 patients. Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol. For other cases, we recommend ORIF with early mobilisation.

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Section: Discussionsupporting

confidence: 88%

Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Distal tibia fractures: management and complications of 101 cases

Joveniaux

Ohl

Harisboure

et al. 2009

International Orthopaedics (SICOT)

148

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“…Nonunion and the need for secondary interventions due to delayed healing are especially common for distal tibial fractures (McFerran et al 1992, Bone et al 1993, Teeny et al 1993, Anglen 1999, Pugh et al 1999, Ristiniemi et al 2007). Thus, early or primary bone grafting is recommended as an essential part of treatment of distal tibial fractures (Ruedi and Allgöver 1969, Teeny et al1993, Tornetta et al 1993, Marsh et al 1995, Sirkin and Sanders 2001, Pugh et al 1999, French and Tornetta 2000, whereas diaphyseal fractures usually heal without secondary interventions.…”

mentioning

confidence: 99%

Staged method using antibiotic beads and subsequent autografting for large traumatic tibial bone loss

et al. 2007

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IntroductionThe vascularity of surrounding soft tissues, which is related to muscle cover, is important for the healing of traumatic bone loss. Muscle cover on the distal tibia is limited compared to the diaphyseal and proximal tibia, and delayed healing of fractures in this area is common. We evaluated the healing of traumatic bone loss in the proximal, diaphyseal, and distal tibia.Patients and methods 23 open tibial fractures with substantial bone loss (mean 52 (34-104) mm) were treated using a staged method with antibiotic-impregnated beads and later autologous bone grafting at second-stage surgery on average 8 weeks after the injury.Results 22 fractures healed after mean 40 (20-79) weeks. The average healing time in the distal tibia (mean 30 weeks) was 7 weeks shorter (95% CI: 12-26 weeks) than in the proximal tibia (37 weeks), and 16 weeks shorter (95% CI: 3-29 weeks) than in the tibial shaft (47 weeks). The length of the bone and the type of soft tissue cover (free muscle or secondary suture) had no effect on healing time.Interpretation Our study suggests that the method we used is applicable in all parts of the tibia, although the healing of bone loss is slower in the diaphyseal tibia than in the proximal and distal tibia.

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Treatment Criteria for Closed Injuries

Brivio¹,

Pizzoli²

2002

Fractures of the Tibial Pilon

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The Treatment of Pilon Fractures

Cited by 72 publications

References 29 publications

Distal tibia fractures: management and complications of 101 cases

Distal tibia fractures: management and complications of 101 cases

Staged method using antibiotic beads and subsequent autografting for large traumatic tibial bone loss

Treatment Criteria for Closed Injuries

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