Comparsion of treatment methods and complitacions in pilon fractures of the tibia
Authors:
Jan Trávník; Libor Paša; Josef Prokeš; Radek Veselý
Authors‘ workplace:
Emergency Hospital Brno, Department of trauma surgery, Medical Faculty Masaryk University Brno, Czech Republic
; Úrazová nemocnice v Brně, Klinika traumatologie, Masarykova univerzita, Brno
Published in:
Úraz chir. 24., 2016, č.3
Overview
Background:
Pilon fractures (Tibial plafond) are frequent and serious injuries. Pacients are treated long time and it causes them both medical and social complications. Goal of pilon fracture treatment is to restore the joint surface either by external fixator or plate.
Study goals:
Comparison of treatment methods of pilon fracture and review of their complications is the principal goal of this study. Results of this study were compared with other recent articles.
Methods:
A retrospective study took place in Emergency Hospital Brno, Department of trauma surgery, Masaryk University. Patients with tibial plafond AO B3, C1 – C3 fractures were involved in the study. They were diveded into two comparable groups. One group was treated by external frame, whereas the other one was treated by LCP plate system. Division was made upon the choice of surgeon in coordinance with type of fracture, soft tissue quality and other external factors. Treatment follow up, Webber clinical evaluation and treatment complications were compared between these two groups.
Results:
Together 67 patients were included in the study, 32 of them treated by LCP plate and 35 with external fixator. All fractures has healed and all patients were able to bear full weight during the 18 month follow-up period. 4 cases of delayed union were seen in the fixator group. Where as in LCP plate group were 4 patients with skin infection.
Conclusion:
Higher incidence of delayed union in the fixator group and tissue infection in the LCP plate group were observed. Despite these results there was no l difference in the clinica outcome between both groups at the end of the 18 month follow-up period. Our results are consistent with conclusions of other authors.
Key words:
Tibial plafond fracture, pilon fracture, external fixator, LCP plate, complications, infection.
Sources
1. BLAUTH, M., BASTIAN, L., KRETTEK, C. Surgical options for the treatment of severe tibial pilon fracutres: A study of three techiques. Orthopaedic. 2001, 3, 153–160. ISSN 0890-5339
2. BOURNE, RB. Pylon fractures of the distal tibia. Clin Orthop Relat Res. 1989, 240. 42–46. ISSN 0009-921X
3. DAVIDOVITCH, RI., ELKATARAN, R., ROMO, S. Open Reduction with Internal Fixation Versus Limited Internal Fixation and External Fixation for High Grade Pilon Fractures (OTA Type 43C). Foot & Ankle International. 2011, 32, 955–961. ISSN 1071-1007
4. HARRIS, AM., PATTERSON, BM., SONITCH, JK. Results and outcomes after operative treatment of high energy tibial plafond fractures. Foot & Ankle International. 2006, 27, 256–265. ISSN 1071-1007
5. HIESTERMAN, TG., SHAFIQ, BX., COLE, PA. Intramedullary nailing of extra-articular proximal tibia fractures. J Am Acad Orthop Surg. 2011, 19, 690–700. ISSN 1940-5480
6. HUGHES, JL., WEBER H., WILLENEGGER, H. Evaluation of Ankle Fratures: Non-Operative and Operative Treatment. Clin Orthop. 1979, 138, 111–119. ISSN 0095-8654
7. JOSTL, J., TIEFENBOCK, TF., HOFBAUER, M., Distal tibial fractures: evaluation of different fixation techniques. Wien Klin Wochenschr. 2015, 03. DOI: 10.1007/s00508-016-1094-6
8. PAPADOKOSTAKIS, G., KONTAKIS, G., GIANNOUDIS. P. External fixation devices in the treatment of fractures of the tibial plafond. J Bone Joint Surg. 2008, 90-B, 1–6. ISSN 1535-1386
9. RICHARDS, JE., MAGILL, M., TRESSLER, MA. et al. External Fixation Versus ORIF for Distal Intra-articular Tibia Fractures. Orthopedics. 2012, 35, e862–e867. ISSN 0890-5339
10. RISTINIEMI, J., LUUKINEN, P., OHTONEN, P. Surgical treatment of extra-articular or simple intra-articular distal tibial fractures: external fixation versus intramedullary nailing. J Orthop Trauma. 2011, 2, 101–105. ISSN 1531-2291
11. RUEDI, TP., ALLGOWER, M. Fractures of the lower end of the tibia into the ankle-joint. Injury. 1969, 1, 92–99. ISSN 0020-1383
12. VALLIER, HA., LE, TT., BEDI, A. Radiographic and Clinical Comparisons of Distal Tibia Shaft Fractures (4 to 11 cm Proximal to the Plafond): Plating Versus Intramedullary Nailing. J Orthop Trauma. 2008, 22, 307–311. ISSN 1531-2291
13. VESELÝ, R., SUCHOMEL, R., KUZMA, J. Zevní fixace v léčbě nitrokloubních zlomenin distální tibie. Úraz chir. 2013, 21, 33–37. ISSN 1211-7080
14. WANG, C., LI, Y., HUANG. L. Comparison of two-staged ORIF and limited internal fixation with external fixator for closed tibial plafond fractures. Arch Orthop Trauma Surg. 2010, 130, 1289–1297. ISSN 1434-3916
15. WANG, D., XIANG, JP., CHEN, XH. A Meta-Analysis for Postoperative Complications in Tibial Plafond Fracture: Open Reduction and Internal Fixation Versus Limited Internal Fixation Combined With External Fixator. The Journal of Foot & Ankle Surgery. 2015, 35, 646–651. ISSN 1071-1007
16. WYRSCH, B., MCFERRAN, MA., MCANDREW, M. et al. Operative treatment of fractures of tibial plafond: A randomized, prospective study. J Bone Joint Surg. 1996, 78-A, 1646–1657. ISSN 1535-1386
17. XUE, XH., YAN, SG., XAI, XG. Intramedullary nailing versus plating for extra-articular distal tibial metaphyseal fracture: A systematic review and meta-analysis Injury Int J. Care Injured. 2014, 667–676. ISSN 0020-1383
18. WILLIAMS, TM., MARSH, JL., NEPOLA, JV. et al. External fixation of tibial plafond fractures: Is routine plating of the fibula necessary? J Orth Trauma. 1998, 12, 16–20. ISSN 1531-2291
Labels
Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
![Issue 3](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/b273cd9e43802857084d2bd281a79235.jpeg)
2016 Issue 3
Most read in this issue
- Comparsion of treatment methods and complitacions in pilon fractures of the tibia
- Closed reduction and intramedullary fixation using Kirchner wires and plate osteosynthesis in the treatment of fractures of distal end of fifth metacarpal bone
- Surgery in the early post-trauma period in patients with triage positive injuries
- Injuries of the Diaphragm