Minimally Invasive Reduction and Fixation Techniques of Pilon Fractures Based on the Preoperative CT Findings.

Autor: Abdelgaid SM; Consultant of Orthopedic Surgery, Helwan University, Helwan, Egypt. Electronic address: sherifmaa@yahoo.com., Hatata DMZ; Consultant of Orthopedic Surgery, AL-Razi Orthopedic Hospital, Kuwait., Elshafey AE; Specialist of Orthopedic Surgery, Helwan University, Helwan, Egypt., Alsharkawy WM; Registrar (Orthop), Al-Razi Orthopedic Hospital, Kuwait.
Jazyk: angličtina
Zdroj: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2022 May-Jun; Vol. 61 (3), pp. 590-603. Date of Electronic Publication: 2021 Oct 23.
DOI: 10.1053/j.jfas.2021.10.018
Abstrakt: Tibial plafond fractures are often associated with significant articular cartilage and soft tissue damage. The presence of co-morbidities has been associated with an increased risk of surgical site complications. With improved in surgical techniques and implants, complication rates have declined; however, the overall prognosis often remains poor. The aims of this study were to evaluate the results of innovative minimally invasive reduction and fixation techniques in tibial plafond fractures based on a CT classification and to compare the difference between short and long-term outcomes. Based on preoperative CT findings, fractures were classified into varus, valgus, anterior, posterior, and neutral types. The minimally invasive reduction and fixation techniques depend on type of fracture, size and location of the intraarticular fragments, and degree of comminution of the extra-articular component. Ninety-one pilon fractures (90 patients) underwent minimally invasive reduction and fixation, of which 7 fractures (7.69%), required open reduction because of intraoperative failure to achieve anatomic reduction. Of the 84 fractures that underwent successful minimally invasive reduction and fixation reported, 35 fractures (41.7%) with excellent outcomes, 40 fractures (47.6%) with good outcomes, 6 fractures (7,1%) with fair outcomes, and 3 fractures (3.6%) had poor outcomes for the long-term American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score (follow-up ≥ 60 months). These results prove that minimally invasive treatment is an effective and durable treatment option for intra-articular pilon fractures. We encourage future clinical studies to further refine minimally invasive techniques for pilon fractures to improve outcomes.
(Copyright © 2021 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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