Treatment of the tibial pilon fractures using the antero-medial fibula approach: Ten case series

Pilon fractures are always results of the high-energy trauma. They are often accompanied with serious soft tissue injury, and tension blisters happened in most cases. For comminuted fractures and poor soft tissue, how to select the incision is challenging. This study aimed to explore the outcomes of...

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Autores principales: Ren, Dong, Wang, Tianci, Liu, Yueju, Liu, Pengbo, Wang, Pengcheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360227/
https://www.ncbi.nlm.nih.gov/pubmed/32664061
http://dx.doi.org/10.1097/MD.0000000000020576
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author Ren, Dong
Wang, Tianci
Liu, Yueju
Liu, Pengbo
Wang, Pengcheng
author_facet Ren, Dong
Wang, Tianci
Liu, Yueju
Liu, Pengbo
Wang, Pengcheng
author_sort Ren, Dong
collection PubMed
description Pilon fractures are always results of the high-energy trauma. They are often accompanied with serious soft tissue injury, and tension blisters happened in most cases. For comminuted fractures and poor soft tissue, how to select the incision is challenging. This study aimed to explore the outcomes of the treatment of ten 43-B/C pilon fractures using an anteromedial fibula approach. Ten closed pilon fractures combined with fibula fractures were treated in our hospital from January 2015 to July 2016. Six cases were AO/OTA type 43-B and 4 cases were 43-C, including 9 males and 1 female with a mean age of 36.3 years (range: 20–60 years). When the skin wrinkled, all patients were treated by the senior authors with open reduction and internal fixation using an anteromedial fibula approach. Postoperatively, patients were followed up at 1 month, 3 months, 6 months, 12 months, and 18 months, respectively. The incision healing, the American Orthopedic Foot and Ankle Society scores and fracture healing were recorded to get a comprehensive evaluation of the effect for the incision. All patients were followed from 9 to 18 months (average: 14.1 months). Anatomic reduction was achieved in 7 cases and satisfactory in 3 cases by the Burwell–Charnley radiological criteria evaluation. All patients had complete retention of the dorsal extensor tendon sheath. The most incisions had a good healing without necrosis at 2 weeks after surgery except 1 case. The factures were healed at a range of 12 to 18 weeks (average: 13.7 ± 1.2 weeks). The American Orthopedic Foot and Ankle Society scores were excellent in 7 cases and good in 3 cases at 1 year after surgery (average: 85.6 ± 4.2 points). The satisfactory outcomes were achieved in most patients. The anteromedial fibula approach used for pilon fractures can lead to an effective exposure and allow fixation of tibia and fibula fractures with minimal soft tissue injury. It is a safe, simple, and effective approach that allows for satisfactory functional rehabilitation of the ankle joint. LEVEL OF EVIDENCE: therapeutic Level IV.
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spelling pubmed-73602272020-08-05 Treatment of the tibial pilon fractures using the antero-medial fibula approach: Ten case series Ren, Dong Wang, Tianci Liu, Yueju Liu, Pengbo Wang, Pengcheng Medicine (Baltimore) 7100 Pilon fractures are always results of the high-energy trauma. They are often accompanied with serious soft tissue injury, and tension blisters happened in most cases. For comminuted fractures and poor soft tissue, how to select the incision is challenging. This study aimed to explore the outcomes of the treatment of ten 43-B/C pilon fractures using an anteromedial fibula approach. Ten closed pilon fractures combined with fibula fractures were treated in our hospital from January 2015 to July 2016. Six cases were AO/OTA type 43-B and 4 cases were 43-C, including 9 males and 1 female with a mean age of 36.3 years (range: 20–60 years). When the skin wrinkled, all patients were treated by the senior authors with open reduction and internal fixation using an anteromedial fibula approach. Postoperatively, patients were followed up at 1 month, 3 months, 6 months, 12 months, and 18 months, respectively. The incision healing, the American Orthopedic Foot and Ankle Society scores and fracture healing were recorded to get a comprehensive evaluation of the effect for the incision. All patients were followed from 9 to 18 months (average: 14.1 months). Anatomic reduction was achieved in 7 cases and satisfactory in 3 cases by the Burwell–Charnley radiological criteria evaluation. All patients had complete retention of the dorsal extensor tendon sheath. The most incisions had a good healing without necrosis at 2 weeks after surgery except 1 case. The factures were healed at a range of 12 to 18 weeks (average: 13.7 ± 1.2 weeks). The American Orthopedic Foot and Ankle Society scores were excellent in 7 cases and good in 3 cases at 1 year after surgery (average: 85.6 ± 4.2 points). The satisfactory outcomes were achieved in most patients. The anteromedial fibula approach used for pilon fractures can lead to an effective exposure and allow fixation of tibia and fibula fractures with minimal soft tissue injury. It is a safe, simple, and effective approach that allows for satisfactory functional rehabilitation of the ankle joint. LEVEL OF EVIDENCE: therapeutic Level IV. Wolters Kluwer Health 2020-07-10 /pmc/articles/PMC7360227/ /pubmed/32664061 http://dx.doi.org/10.1097/MD.0000000000020576 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 7100
Ren, Dong
Wang, Tianci
Liu, Yueju
Liu, Pengbo
Wang, Pengcheng
Treatment of the tibial pilon fractures using the antero-medial fibula approach: Ten case series
title Treatment of the tibial pilon fractures using the antero-medial fibula approach: Ten case series
title_full Treatment of the tibial pilon fractures using the antero-medial fibula approach: Ten case series
title_fullStr Treatment of the tibial pilon fractures using the antero-medial fibula approach: Ten case series
title_full_unstemmed Treatment of the tibial pilon fractures using the antero-medial fibula approach: Ten case series
title_short Treatment of the tibial pilon fractures using the antero-medial fibula approach: Ten case series
title_sort treatment of the tibial pilon fractures using the antero-medial fibula approach: ten case series
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360227/
https://www.ncbi.nlm.nih.gov/pubmed/32664061
http://dx.doi.org/10.1097/MD.0000000000020576
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