Lateral Transfibular Approach to Tibial Pilon Fractures: A Case Report

2019 ◽  
Vol 109 (6) ◽  
pp. 459-462
Author(s):  
Bilgehan Tosun ◽  
Ozgur Selek
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Distal Tibia ◽  
Lateral Part ◽  
Pilon Fracture ◽  
Tibial Pilon ◽  
Tibial Pilon Fracture ◽  
Second Year ◽  
Pilon Fractures

We present a case of tibial pilon fracture where only the lateral part of the distal tibia was affected. The transfibular approach to the ankle was used for the surgical treatment of the fracture. After an initial nonweightbearing period of 3 weeks, full weightbearing was allowed 8 weeks after surgery. The second-year follow-up showed no evidence of degenerative signs, with full ankle range of motion.

scholarly journals PO 18143 - AO type 43C tibial pilon fractures

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. S29
Author(s):  
Kelly Cristina Stéfani ◽  
Vinicius Quadros Borges ◽  
Gabriel Ferraz Ferreira ◽  
Leonardo Vinícius De Matos Moraes
Keyword(s):  
Cartilage Damage ◽  
Treatment Protocol ◽  
Anatomical Reconstruction ◽  
Pilon Fracture ◽  
Tibial Pilon ◽  
Tibial Pilon Fracture ◽  
Osteosynthesis Material ◽  
Soft Tissue Involvement ◽  
Final Treatment ◽  
Pilon Fractures

Objective: The objective of this study was to prospectively evaluate operated cases of AO type 43C tibial pilon fracture and to assess factors that might influence functional outcomes during the late postoperative period.  Methods: Patients were classified according to the OTA/AO Classification using X-ray and computed tomography (CT) scans. Patients with type 43C fractures were included in this study. A total of 98 tibial pilon osteosynthesis surgeries were performed, and 35 cases were selected for this study based on the inclusion criteria. The treatment protocol established was based on the Tscherne Classification.  Results: We observed that immediate skin complications might be a prognostic factor for the late removal of osteosynthesis material (mean = 2 years postoperation) because an association was found between skin complications and the removal of osteosynthesis material. We observed a high incidence of late arthritis complications in both groups, which indicates that post-traumatic arthritis associated with 43C pilon fractures is practically certain.  Conclusion: No differences were found between the groups when correlating the American Foot and Ankle Score (AOFAS), the degree of arthritis, and skin complications; therefore, complications did not determine the outcomes of tibial pilon fracture. Although the cartilage damage that occurs at the time of injury is a significant mediator of the clinical outcome, more important factors affect the final treatment outcome. In our study, these factors were the treatment protocol based on soft tissue involvement, anatomical reconstruction of the joint, and rigid internal fixation with early range of motion.

scholarly journals Ankle joint reconstruction by circular frame external fixator for a severely comminuted and contaminated open tibial pilon fracture (AO 43-C3.3). Case report

2019 ◽  
Vol 23 ◽  
pp. 100234
Author(s):  
Shota Harada ◽  
Tsukasa Teramoto ◽  
Motoyuki Takaki ◽  
Tomohiko Asahara ◽  
Narutaka Katoh ◽  
...  
Keyword(s):  
Case Report ◽  
Ankle Joint ◽  
External Fixator ◽  
Pilon Fracture ◽  
Joint Reconstruction ◽  
Tibial Pilon ◽  
Tibial Pilon Fracture ◽  
Circular Frame

Minimal Surgical Treatment of the Tibial Pilon Fracture

1999 ◽  
Vol 12 (1) ◽  
pp. 113
Author(s):  
Min Young Chung ◽  
Chang Woo Kim ◽  
Joon Kwon Jung ◽  
Eun Hwan Bae ◽  
Ho Keun Park ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pilon Fracture ◽  
Tibial Pilon ◽  
Tibial Pilon Fracture

Ankle-joint salvage following a tibial pilon fracture. A case report

1998 ◽  
Vol 88 (2) ◽  
pp. 80-83 ◽  
Author(s):  
MK O'Shea ◽  
KA Lewis
Keyword(s):  
Case Report ◽  
Ankle Joint ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Alternative Form ◽  
Mechanism Of Injury ◽  
Pilon Fracture ◽  
Tibial Pilon ◽  
Tibial Pilon Fracture ◽  
Vehicle Accident

This article presents a case of a tibial pilon fracture following a motor-vehicle accident. It discusses the main classification system and mechanism of injury for such fractures and emphasizes an alternative form of treatment of the usually suggested ankle fusion: an arthrectomy, which allows motion, thereby salvaging the ankle joint.

External Fixation in the Treatment of Tibial Pilon Fractures: Comparison of Two Frames in Torsion

2007 ◽  
Vol 28 (7) ◽  
pp. 823-830 ◽  
Author(s):  
Aaron T. Scott ◽  
John R. Owen ◽  
Vishal Khiatani ◽  
Robert S. Adelaar ◽  
Jennifer S. Wayne
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Statistical Significance ◽  
Testing Machine ◽  
Distal Tibia ◽  
Materials Testing ◽  
Pilon Fracture ◽  
Tibial Pilon ◽  
Torsional Testing ◽  
Pilon Fractures

Background Ankle spanning external fixation has become the initial treatment of choice for complex tibial pilon fractures. Many fixator designs exist, but their biomechanical performance has not been studied extensively for this application. The goal of the present study was to compare the torsional performance of two commercially available frames, the Orthofix XCaliber and the Howmedica Hoffmann® II. Methods The XCaliber and the Hoffmann® II were each applied to six fresh cadaver lower extremities and were loaded in a materials testing machine. Strain gauges were attached to the anteromedial cortex of the distal tibia, and each specimen underwent torsional and axial load testing, with and without the external fixator. A simulated pilon fracture was created, and torsional testing was repeated. Results Results indicated that the XCaliber was significantly more rigid in internal rotation than the Hoffmann® II, before (49%) and after (41%) creation of the pilon fracture. Despite the XCaliber's increased rigidity relative to the Hoffmann® II (22% to 31%) in external rotation, statistical significance was not attained. Both fixators reduced strain (25% to 85%) at the anteromedial cortex upon torsional testing, but no significant differences between the two frames were noted. Conclusions The present study demonstrates that the XCaliber has mechanical advantages over the Hoffmann® II in terms of torsional rigidity for a tibial pilon fracture. Clinical Relevance Increased rigidity of the XCaliber could potentially lead to decreased time to union, and a lower incidence of pin loosening and would prove beneficial in a setting in which the external fixator is used as the definitive fixation.

scholarly journals AO type 43C tibial pilon fractures

2018 ◽  
Vol 12 (3) ◽  
pp. 233-239
Author(s):  
Vinícius Quadros Borges ◽  
Leonardo Vinícius de Matos Moraes ◽  
Gabriel Ferraz Ferreira ◽  
Kelly Cristina Stéfani
Keyword(s):  
Cartilage Damage ◽  
Treatment Protocol ◽  
Anatomical Reconstruction ◽  
Pilon Fracture ◽  
Level Of Evidence ◽  
Tibial Pilon ◽  
Tibial Pilon Fracture ◽  
Osteosynthesis Material ◽  
Soft Tissue Involvement ◽  
Pilon Fractures

Objective: The objective of this study was to prospectively evaluate operated cases of AO type 43C tibial pilon fracture and assess which factors might influence functional outcomes during the late postoperative period.Methods: Patients were classified according to the OTA/AO Classification using X-ray and computed tomography (CT) scans. Patients with type 43C fractures were included in this study. A total of 98 tibial pilon osteosynthesis surgeries were performed, and 35 cases were selected for this study based on the inclusion criteria. The treatment protocol established was based on the Tscherne Classification. Results: We observed that immediate skin complications might be a prognostic factor for the late removal of osteosynthesis material (mean=2 years postoperation) because an association was found between skin complications and the removal of osteosynthesis material. We observed a high incidence of late arthritis complications in both groups, which indicates that the post-traumatic arthritis associated with 43C pilon fractures is practically certain. Conclusions: No differences were found between the groups when correlating the American Foot and Ankle Score (AOFAS), the degree of arthritis, and skin complications; therefore, complications did not determine the outcomes of tibial pilon fracture. Although the cartilage damage that occurs at the time of injury is a significant mediator of the clinical outcome, more important factors affect the final treatment outcome. In our study, these factors were the treatment protocol based on soft tissue involvement, the anatomical reconstruction of the joint, and rigid internal fixation with early range of motion. Level of Evidence II; Therapeutic Studies; Comparative Prospective.

Should the location of distal tibial plating be influenced by the varus or valgus fracture pattern of tibial pilon fracture?

2021 ◽  
Author(s):  
Choon Chiet Hong ◽  
Soura Saha ◽  
Si Heng Sharon Tan ◽  
Ken Jin Tan ◽  
Diarmuid Paul Murphy ◽  
...  
Keyword(s):  
Fracture Pattern ◽  
Pilon Fracture ◽  
Tibial Pilon ◽  
Tibial Pilon Fracture

scholarly journals Should Complex Comminuted C3-Type Tibial Pilon Fractures Be Fused or Fixated? A Systematic Review

2021 ◽  
Author(s):  
Yash Paul Chaudhry ◽  
Efstratios Papadelis ◽  
Hunter Hayes ◽  
Philip F. Stahel ◽  
Erik A. Hasenboehler
Keyword(s):  
Fracture Fixation ◽  
Complication Rate ◽  
Wound Complication ◽  
Ankle Arthrodesis ◽  
Pilon Fracture ◽  
Eligibility Criteria ◽  
Tibial Pilon ◽  
Mesh Terms ◽  
The Mean ◽  
Pilon Fractures

Abstract Background: Comminuted intra-articular tibial pilon fractures can be challenging to manage, with high revision rates and poor functional outcomes. This study reviewed (1) treatment, complications, and clinical outcomes in studies of complex comminuted tibial pilon fractures (type AO43-C3); and (2) primary ankle arthrodesis as a management option for these types of complex injuries.Methods: A systematic literature search was performed on PubMed from 1990-2020 to determine complications and outcomes after staged fracture fixation and primary ankle joint arthrodesis for comminuted C3-type tibial pilon fractures.The search was conducted in compliance with the PRISMA guidelines, using the following MeSH terms: “tibial pilon”/“pilon fracture”/“plafond fracture”/“distal tibial”/“43-C3”/“ankle fracture”/“ankle fusion”/“primary ankle arthrodesis”/“pilon fracture staged”/“pilon external fixation” and “pilon open reduction internal fixation.” Inclusion criteria were restricted to original articles in English language on adult patients ≥18 years of age. Eligibility criteria for retrieved publications were determined using a “PICO” approach (population, intervention/exposure, comparison, outcomes). Weighted analysis was used to compare treatment groups on time to definitive treatment, follow-up time, range of motion, fracture classification, and complications.Results: The systematic literature review using the defined MeSH terms yielded 72 original articles. Of these, 13 articles met the eligibility criteria based on the PICO statements, of which 8 publications investigated the outcomes of a staged fixation approach in 308 cumulative patients, and 5 articles focused on primary ankle arthrodesis in 69 cumulative patients. For staged treatment, the mean wound complication rate was 14.6%, and the malunion/nonunion rate was 9.9%. For primary arthrodesis, the mean wound complication rate was 2.9%, and the malunion/nonunion rate was 2.9%. After risk stratification for fracture type and severity, the small cumulative cohort of patients included in the primary arthrodesis publications did not provide sufficient power to determine a clinically relevant difference in complications and long-term patient outcomes compared to the staged surgical fixation group.Conclusions: At present, there is insufficient evidence in the published literature to provide guidance towards consideration of ankle arthrodesis for complex comminuted C3-type tibial pilon fractures, compared to the standard treatment by staged surgical fracture fixation.

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