Posterior pilon fracture: Epidemiology and surgical technique
| Autor: | Maximiliano Barahona, Manuel J. Pellegrini, Christian Urbina, Christian Bastias, Fernando Vargas, Felipe Chaparro, Leonardo Lagos, Ximena Ahumada |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Ankle Fractures Pilon fracture Fracture Fixation Internal 03 medical and health sciences Postoperative Complications 0302 clinical medicine Epidemiology Humans Medicine Internal fixation Ankle Injuries Chile Reduction (orthopedic surgery) General Environmental Science Fixation (histology) 030222 orthopedics business.industry Trauma center 030208 emergency & critical care medicine Consecutive case series medicine.disease Surgery Outcome and Process Assessment Health Care medicine.anatomical_structure Fibula General Earth and Planetary Sciences Female Ankle Tomography X-Ray Computed business |
| Zdroj: | Injury. 50:2312-2317 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2019.10.007 |
| Popis: | Objectives To review a case series of patients with posterior pilon variant fracture using a novel approach, focusing on demographic data, injury pattern, surgical results based on computed tomography (CT) scan, and short-term complications. Design Consecutive case series. Setting Level I trauma center. Patients/participants Twenty-five patients with posterior pilon fracture. Intervention Posterior pilon fracture open reduction and internal fixation. Main Outcome Measurements Parameters measured included age, sex, type of fracture, surgical technique, anatomical reduction, and complications. Results Twenty-five patients sustained a posterior pilon fracture, accounting for 13.4% of all operatively treated ankle fractures with median follow-up of 21.7 months. The average age of patients was 42 years (22–62); 19/25 (76%) were female, and 6/25 (24%) were male. A modified posteromedial approach was used in 18/25 (72%) patients. Persistent syndesmotic instability was present in 11/25 (44%) patients after posterior malleolar stabilization. Quality of reduction was assessed under CT scan in 19 patients, with 15/19 (78.9%) having anatomic reduction. We report 2/25 (8%) patients with early wound problems and 7/25 (20%) with short-term complications during follow-up. Conclusion Posterior pilon variant fracture appears to be less common than previously reported. Most fractures can be satisfactorily treated through a modified posteromedial approach. Albeit obtaining posterior malleolar fracture rigid fixation, syndesmotic instability was more prevalent than expected. The short-term complication rate was low. Level of Evidence Therapeutic level IV. |
| Databáze: | OpenAIRE |
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