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Published in: MUSCULOSKELETAL SURGERY 1/2019

01-04-2019 | Original Article

Tibial pilon fractures treated with hybrid external fixator: analysis of 75 cases

Authors: M. Scaglione, F. Celli, F. Casella, L. Fabbri

Published in: MUSCULOSKELETAL SURGERY | Issue 1/2019

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Abstract

Introduction

The treatment of tibial pilon fractures is a surgical challenge due to the particular anatomical and vascular characteristics of this area, and the severity of the injury that can compromise soft tissues. Nowadays there is no gold-standard treatment for these fractures.

Materials and methods

We reviewed 75 patients with tibial pilon fracture type C (AO classification) treated with hybrid external fixation (Stryker TenXor®). The surgical technique was reported. We evaluated clinical (Tornetta’s score, VAS score, range of motion) and radiographic outcomes.

Results

In 71 cases, the first surgical treatment was definitive. Instead, in four cases, it was necessary a second surgical procedure to achieve fracture healing. We obtained 44% excellent, 40% good, 7% discrete, and 9% bad results. We found a 30% of superficial infections of the pin site, resolved with oral antibiotic treatment (amoxicillin and clavulanic acid). We never had deep infections, no neurovascular injury, and no cases of secondary amputation. Although not statistically significant, we noticed a correlation between longer recovery times and trauma severity, with slower recovery in open or grade III fractures or when associated with other fractures.

Conclusions

According to the recent literature, we think that the best treatment for non-articular fracture is the internal osteosynthesis within 6 h or after 6 days from trauma. In articular fractures, the elective treatment is the two-step management. In complicated articular fractures (Tscherne > 2, open, comminuted type III) is highly indicated the external fixation combined with minimal internal synthesis.
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Metadata
Title
Tibial pilon fractures treated with hybrid external fixator: analysis of 75 cases
Authors
M. Scaglione
F. Celli
F. Casella
L. Fabbri
Publication date
01-04-2019
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue 1/2019
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-018-0550-z

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