Factors affecting the results of tibial pilon fractures treated with open reduction internal fixation

The purpose of this study is to evaluate the short and medium term functional results of tibial pilon fractures treated in our clinic with the open reduction and internal fixation method and to investigate the factors affecting such results. 41 patients who were treated in our clinic between 1995 and 2009 with open reduction and internal fixation were included in this study. Looking at the postoperative radiographs, quality of reduction was evaluated as per the criteria of Ovadia and Beals. Functional results of the patients were assessed in line with the criteria of Teeny and Wiss. With the evaluation of postoperative radiographs, 17 (41.5%) excellent and good, 21 (51.2%) fair and 3 (7.3%) poor results were obtained. Functionally speaking, 26 patients (63.5%) displayed excellent and good, 8 displayed (19.5%) fair and 7 displayed (17%) poor results. It was found out that age, sex, the time spent before the operation, the period of immobilization following the operation and the presence of an accompanying fracture did not have a significant impact on the functional results. It was revealed that the type of fracture affects functional results. A positive correlation was found between the quality of reduction and the functional results. In the light of the findings of this study, it was concluded that in tibial pilon fractures treated with the internal fixation method, the type of fracture and the quality of reduction are important in identifying the short and medium term prognosis.

___

McCann PA, Jackson M, Mitchell ST, Atkins RM. Complications of definitive open reduction and internal fixation of pilon fractures of the distal tibia. Int Orthop. 2011;35(3):413-8.

Güven M, Ceviz E, Demirel M, Özler T, Kocadal O, Onal A. Minimally invasive osteosynthesis of adult tibia fractures by means of rigid fixation with anatomic locked plates. Strategies Trauma Limb Reconstr. 2013;8(2):103-9.

Jansen H, Fenwick A, Doht S, Frey S, Meffert R. Clinical outcome and changes in gait pattern after pilon fractures. Int Orthop. 2013;37(1):51-58.

Bacon S, Smith WR, Morgan SJ, Hasenboehler E, Philips G, Williams A, Ziran BH, Stahel PF. A retrospective analysis of comminuted intra-articular fractures of the tibial plafond: Open reduction and internal fixation versus external Ilizarov fixation. Injury. 2008;39(2):196-202.

Conroy J, Agarwal M, Giannoudis PV, Matthews SJ. Early internal fixation and soft tissue cover of severe open tibial pilon fractures. Int Orthop. 2003;27(6):343-7.

Jacob N, Amin A, Giotakis N, Narayan B, Nayagam S, Trompeter AJ. Management of high-energy tibial pilon fractures. Strategies Trauma Limb Reconstr. 2015;10(3):137-47.

Sirkin M, Sanders R, DiPasquale T, Herscovici D Jr. A staged protocol for soft tissue management in the treatment of complex pilon fractures. J Orthop Trauma. 1999;13(2):78-84.

Pollak AN, McCarthy ML, Bess RS, Agel J, Swiontkowski MF. Outcomes after treatment of high-energy tibial plafond fractures. J Bone Joint Surg Am. 2003;85-A(10):1893-900.

Marsh JL, Weigel DP, Dirschl DR. Tibial plafond fractures. How do these ankles function over time? J Bone Joint Surg Am. 2003;85-A(2):287-95.

Teeny SM, Wiss DA. Open reduction and internal fixation of tibial plafond fractures: Variables contributing to poor results and complications, Clin Orthop Relat Res. 1993;292:108-17.

Tarkin IS, Clare MP, Marcantonio A, Pape HC. An update on the management of high-energy pilon fractures. Injury. 2008;39(2):142-54.

Schatzker J. Fractures of the distal femur revisited. Clin Orthop Relat Res. 1998;347:43-56.

Patterson MJ, Cole JD. Two-staged delayed open reduction and internal fixation of severe pilon fractures. J Orthop Trauma. 1999;13(2):85-91.

Dillin L, Slabaugh P. Delayed wound healing, infection, and nonunion following open reduction and internal fixation of tibial plafond fractures. J Trauma 1986;26(12):1116-9.

Blauth M, Bastian L, Krettek C, Knop C, Evans S. Surgical options for the treatment of severe tibial pilon fractures: a study of three techniques. J Orthop Trauma. 2001;15(3):153-60.

Ebraheim N, Sabry FF, Mehalik JN. Intraoperative imaging of the tibial plafond fracture: a potential pitfall. Foot Ankle Int. 2000;21(1):67-72.

Muhr G, Breitfuss H. Complications after pilon fractures. In: Major Fractures of the Pilon, the Talus, and the Calcaneus, ed by Tscherne H, Schatzker J. Berlin, Springer-Verlag, 1993;65-8.

Sands A, Grujic L, Byck DC, Agel J, Benirschke S, Swiontkowski MF. Clinical and functional outcomes of internal fixation of displaces pilon fractures, Clin Orthop Relat Res. 1998;347:131-7.

Kao KF, Huang PJ, Chen YW, Cheng YM, Lin SY, Ko SH. Postero-medioanterior approach of the ankle for the Pilon fracture. Injury. 2000;31(2):71-4.

Bone L, Stegemann P, McNamara K, et al. External fixation of severely comminuted and open pilon fractures. In: Major Fractures of the Pilon, the Talus, and the Calcaneus, ed by Tscherne H, Schatzker J. Berlin, Springer- Verlag, 1993;53-8.

Ovadia DN, Beals RK. Fractures of the tibial plafond, J Bone Joint Surg Am. 1986;68(4)543-5-51.

Etter C, Ganz R. Long trem results of tibial plafond fractures treated with open reduction and internal fixation. Arch Orthop Traum Surg. 1991;110(6):277-83.

Wyrsch B, McFerran MA, McAndrew M, Limbird TJ, Harper MC, Johnson KD, Schwartz HS. Operative treatment of fractures of the tibial plafond: A randomized, prospective study, J Bone Joint Surg Am. 1996;78(11):1646-57.

Kellam JF, Waddell JP. Fractures of the distal tibial metaphysis with intra-articular extension--the distal tibial explosion fracture. J Trauma 1979;19(8):593-601.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Correlation between red cell distribution width and grade of hepatic steatosis and liver enzymes in patients with Non-Alcoholic steatohepatitis

ALİ DOĞAN, Narin YILDIRIM DOĞAN, ÖMER EKİNCİ, Melih KARINCAOĞLU

Factors affecting the results of tibial pilon fractures treated with open reduction internal fixation

Mehmet Yavuz BAŞER, AYDIN ARSLAN, Ali UTKAN, Bülent ÖZKURT

Bone mass and bone turnover in premenopausal women with fibromyalgia syndrome

Ali GÜRBÜZ, ARZU KAYA, TANSEL ANSAL BALCI

Effectiveness of a health improving model on oral health behavior for adolescents by nursing interventions

FADİME ÜSTÜNER TOP, Ayşe Ferda OCAKCI

Investigation of the microorganisms decaying blood evidences

Murat OGDUR, Hüseyin ÇAKAN, FİLİZ EKİM ÇEVİK

Dermoscopic findings in psoriasis and seborrheic dermatitis on the scalp and correlation with disease severity

SEZİN FIÇICIOĞLU, SÜLEYMAN PİŞKİN

An investigation of infection rate and seasonal effect level in total joint replacement cases

REŞİT SEVİMLİ, Okan ASLANTÜRK, KADİR ERTEM, Ahmet HARMA, Gökay GÖRMELİ, AYDIN ARSLAN

Ophthalmoplegia secondary to left sphenoid sinus mucocele

Serhat YASLIKAYA, Yüksel TOPLU, İsmail DEMİR, Erkan KARATAŞ

Relationship between living arrangements, quality of life and depressive symptoms of older adults

Hatice YİĞEN, Osman GÜNAY, ARDA BORLU

Asymptomatic calf vein DVT in high risk surgical patients: A single centre study

Gouriprasad KURUMAPU, Manas R. PATTNAİK, Madhusudan DEY