Do diff Do different sur ent surgical techniques in tibia pilon fr gical techniques in tibia pilon fractures change the es change the results of the midterm?

Do diff Do different sur ent surgical techniques in tibia pilon fr gical techniques in tibia pilon fractures change the es change the results of the midterm?

Background/aim: Pilon fracture is difficult to treat fractures due to many complications that can develop after surgery. To achieve the best results, different surgical approaches are used.In our study, we aimed to compare the functional results and complication rates of our treatments in patients treated with 3 different surgical tecniques. Materials and methods: 89 pilon fractures of 87 patients treated for pilon fracture were evaluated. Patients were examined in 3 different groups (one step, two step surgery and Ilizarov). Functional results, postoperative complications and ankle AOFAS scores were evaluated. Results: The mean AOFAS score of the all patients was 77.67. There was no significant difference between 3 surgical techniques (P = 0,880). While skin complication was not seen in patients who underwent double-stage surgery and Ilizarov (0%); It was seen in 6 (15.7%) patients who underwent single-stage surgery. Treatment results were found to be better in type 1 and type 2 fractures, while in type 3 fractures (P = 0.004). Conclusion: Despite the different surgical approaches and implants applied, no difference was found between the midterm ankle functional results of the patients. Two-stage surgery and Ilizarov is a safe and effective treatment approach to reduce morbidity and early complications in pilon fractures.

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  • 1. Carter TH, Duckworth AD, Oliver WM, Molyneux SG, Amin AK et al. Open reduction and internal fixation of distal tibial pilon fractures. JBJS Essential Surgical Techniques 2019; 9 (3): e29. doi: 10.2106/JBJS.ST.18.00093
  • 2. Beaman DN, Gellman R. Fracture reduction and primary ankle arthrodesis: a reliable approach for severely comminuted tibial pilon fracture. Clinical Orthopaedics and Related Research 2014; 472 (12): 3823-3834. doi: 10.1007/s11999-014-3683-x
  • 3. Barış A, Çirci E, Demirci Z, Öztürkmen Y. Minimally invasive medial plate osteosynthesis in tibial pilon fractures: longterm functional and radiological outcomes. Acta Orthopaedica et Traumatologica Turcica 2020; 54 (1): 20-26. doi: 10.5152/j. aott.2020.01.489
  • 4. Saad BN, Yingling JM, Liporace FA, Yoon RS. Pilon fractures: challenges and solutions. Orthopedic Research and Reviews 2019; 11: 149-157. doi: 10.2147/ORR.S170956
  • 5. McCann PA, Jackson M, Mitchell ST, Atkins RM. Complications of definitive open reduction and internal fixation of pilon fractures of the distal tibia. International Orthopaedics 2011; 35 (3): 413-418. doi: 10.1007/s00264-010-1005-9
  • 6. Bingol I, Yalcin N, Bicici V, Tulunay T, Yuksel K et al. Minimally invasive percutaneous plate osteosynthesis does not increase complication rates in extra-articular distal tibial fractures. The Open Orthopaedics Journal 2015; 9: 73-77. doi: 10.2174/1874325001509010073
  • 7. Davidovitch RI, Elkhechen RJ, Romo S, Walsh M, Egol KA. Open reduction with internal fixation versus limited internal fixation and external fixation for high grade pilon fractures (OTA type 43C). Foot and Ankle International 2011; 32 (10): 955-961. doi: 10.3113/FAI.2011.0955
  • 8. Bacon S, Smith WR, Morgan SJ, Hasenboehler E, Philips G et al. A retrospective analysis of comminuted intra-articular frac-tures of the tibial plafond: Open reduction and internal fixation ver-sus external Ilizarov fixation. Injury 2008; 39 (2): 196-202. doi: 10.1016/j.injury.2007.09.003
  • 9. Rüedi TP, Allgöwer M. Fractures of the lower and of the tibia into the ankle joint. İnjury 1969; 1 (2): 92-99. doi: 10.1016/ S0020-1383(69)80066-5
  • 10. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: ret-rospective and prospective analyses. The Journal of Bone and Joint Surgery 1976; 58 (4): 453-458. doi: 10.2106/00004623-197658040-00004
  • 11. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot and Ankle International 1994; 15 (7): 349-353. doi: 10.1177/107110079401500701
  • 12. Freedman EL, Johnson EE. Radiographic analysis of tibial fracture malalignment following intramedullary nailing. Clinical Orthopaedics and Related Research 1995; 315:25-33
  • 13. Jansen H, Fenwick A, Doht S, Frey S, Meffert R. Clinical outcome and changes in gait pattern after pilon fractures. International Orthophaedics 2013; 37 (1): 51-58. doi: 10.1007/ s00264-012-1716-1
  • 14. Ketz J, Sanders R. Staged posterior tibial plating for the treatment of Orthopaedic Trauma Association 43C2 and 43C3 tibial pilon fractures. Journal of Orthopedic Trauma 2012; 26 (6): 341-347. doi: 10.1097/BOT.0b013e318225881a
  • 15. Zhao L, Li Y, Chen A, Zhang Z, Xi J et al. Treatment of type C pilon fractures by external fixator combined with limited open reduction and absorbable internal fixation. Foot and Ankle International 2013; 34 (4): 534-542. doi: 10.1177/1071100713480344
  • 16. Hebert-Davies J, Kleweno CP, Nork SE. Contemporary strategies in pilon fixation. Journal of Orthopaedic Trauma 2020; 34 (1): 14-20. doi: 10.1097/BOT.0000000000001698
  • 17. Esposito JG, Van der Vliet QMJ, Heng M, Potter J, Cronin PK et al. Does surgical approach influence the risk of postoperative infection following surgical treatment of tibial pilon fractures? Journal of Orthopaedic Trauma 2020; 34 (3): 126- 130. doi: 10.1097/BOT.0000000000001655
  • 18. Patterson MJ, Cole JD. Two staged delayed open reduction and internal fixation of severe pilon fractures. Journal of Orthopaedic Trauma 1999; 13 (2): 85-91. doi: 10.1097/00005131-199902000-00003
  • 19. Sirkin M, Sanders R, DiPasquale T, Herscovici D Jr. A staged protocol for soft tissue management in the treatment of complex pilon fractures. Journal of Orthopaedic Trauma 2004; 18 (8): 32-38. doi: 10.1097/00005131-200409001-00005
  • 20. Sands A, Grujic L, Byck DC, Agel J, Benirschke S et al. Clinical and functional outcomes of internal fixastion of displaced pilon fractures. Clinical Orthopaedics and Related Research 1998; 347: 131-137.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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