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Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation

BACKGROUND: Tibial platfond fractures are usually associated with massive swelling of the foot and ankle, as well as with open wounds. This swelling may cause significant decrease of the blood flow, so the state of the soft tissue is determinant for the surgical indication and the type of implant. T...

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Autores principales: Cisneros, Luis Natera, Gómez, Mireia, Alvarez, Carlos, Millán, Angélica, De Caso, Julio, Soria, Laura
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800953/
https://www.ncbi.nlm.nih.gov/pubmed/27053800
http://dx.doi.org/10.4103/0019-5413.177577
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author Cisneros, Luis Natera
Gómez, Mireia
Alvarez, Carlos
Millán, Angélica
De Caso, Julio
Soria, Laura
author_facet Cisneros, Luis Natera
Gómez, Mireia
Alvarez, Carlos
Millán, Angélica
De Caso, Julio
Soria, Laura
author_sort Cisneros, Luis Natera
collection PubMed
description BACKGROUND: Tibial platfond fractures are usually associated with massive swelling of the foot and ankle, as well as with open wounds. This swelling may cause significant decrease of the blood flow, so the state of the soft tissue is determinant for the surgical indication and the type of implant. This retrospective study compares the union times in cases of tibial plafond fractures managed with a hybrid external fixation as a definitive procedure versus those managed with a two stage strategy with final plate fixation. MATERIALS AND METHODS: A retrospective study in a polytrauma referral hospital was performed between 2005 and 2011. Patients with a tibial plafond fracture, managed with a hybrid external fixation as a definitive procedure or managed with a two stage strategy with the final plate fixation were included in the study. Postoperative radiographs were evaluated by two senior surgeons. Fracture healing was defined as callus bridging of one cortex, seen on both lateral and anteroposterior X-ray. The clinical outcome was evaluated by means of 11 points Numerical Rating Scale for pain and The American Orthopedic Foot and Ankle Society ankle score, assessed at the last followup visit. Thirteen patients had been managed with a hybrid external fixation and 18 with a two-stage strategy with the final plate fixation. There were 14 males and 17 females with a mean age of 48 years (range 19–82 years). The mean followup was 24 months (range 24–70 months). RESULTS: The mean time from surgery to weight bearing was 7 ± 6.36 days for the hybrid fixation group and 57.43 ± 15.46 days for the plate fixation group (P < 0.0001); and the mean time from fracture to radiological union was 133.82 ± 37.83) and 152.8 ± 72.33 days respectively (P = 0.560). CONCLUSION: Besides the differences between groups regarding the baseline characteristics of patients, the results of this study suggest that in cases of tibial plafond fractures, the management with a hybrid external fixation as a definitive procedure might involve a faster union than a two-stage management with final plate fixation.
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spelling pubmed-48009532016-04-06 Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation Cisneros, Luis Natera Gómez, Mireia Alvarez, Carlos Millán, Angélica De Caso, Julio Soria, Laura Indian J Orthop Knee Symposium BACKGROUND: Tibial platfond fractures are usually associated with massive swelling of the foot and ankle, as well as with open wounds. This swelling may cause significant decrease of the blood flow, so the state of the soft tissue is determinant for the surgical indication and the type of implant. This retrospective study compares the union times in cases of tibial plafond fractures managed with a hybrid external fixation as a definitive procedure versus those managed with a two stage strategy with final plate fixation. MATERIALS AND METHODS: A retrospective study in a polytrauma referral hospital was performed between 2005 and 2011. Patients with a tibial plafond fracture, managed with a hybrid external fixation as a definitive procedure or managed with a two stage strategy with the final plate fixation were included in the study. Postoperative radiographs were evaluated by two senior surgeons. Fracture healing was defined as callus bridging of one cortex, seen on both lateral and anteroposterior X-ray. The clinical outcome was evaluated by means of 11 points Numerical Rating Scale for pain and The American Orthopedic Foot and Ankle Society ankle score, assessed at the last followup visit. Thirteen patients had been managed with a hybrid external fixation and 18 with a two-stage strategy with the final plate fixation. There were 14 males and 17 females with a mean age of 48 years (range 19–82 years). The mean followup was 24 months (range 24–70 months). RESULTS: The mean time from surgery to weight bearing was 7 ± 6.36 days for the hybrid fixation group and 57.43 ± 15.46 days for the plate fixation group (P < 0.0001); and the mean time from fracture to radiological union was 133.82 ± 37.83) and 152.8 ± 72.33 days respectively (P = 0.560). CONCLUSION: Besides the differences between groups regarding the baseline characteristics of patients, the results of this study suggest that in cases of tibial plafond fractures, the management with a hybrid external fixation as a definitive procedure might involve a faster union than a two-stage management with final plate fixation. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4800953/ /pubmed/27053800 http://dx.doi.org/10.4103/0019-5413.177577 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Knee Symposium
Cisneros, Luis Natera
Gómez, Mireia
Alvarez, Carlos
Millán, Angélica
De Caso, Julio
Soria, Laura
Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation
title Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation
title_full Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation
title_fullStr Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation
title_full_unstemmed Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation
title_short Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation
title_sort comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation
topic Knee Symposium
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800953/
https://www.ncbi.nlm.nih.gov/pubmed/27053800
http://dx.doi.org/10.4103/0019-5413.177577
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