Vito N Galante1, Giovanni Vicenti2, Gianfranco Corina3, Claudio Mori4, Antonella Abate5, Girolamo Picca4, Vito Conserva4, Domenico Speciale6, Lorenzo Scialpi6, Nicola Tartaglia7, Vincenzo Caiaffa8, Biagio Moretti4. 1. Orthopaedics and Traumatology Department, Az Unita'Sanitaria Locale TA 1, Castellaneta, TA, Italy. 2. Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy. Electronic address: dott.gvicenti@gmail.com. 3. Department of Orthopaedics and Traumatology, Dario Camberlingo Hospital, Francavilla Fontana, Italy. 4. Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy. 5. Department of Orthopaedics and Traumatology, Monsignor Raffaele Dimiccoli Hospital, Barletta, Italy. 6. Department of Orthopaedics and Traumatology, SS Annunziata Hospital, Taranto, Italy. 7. Orthopaedics and Traumatology Department, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy. 8. Orthopaedics and Traumatology Department, Di Venere Hospital, Bari, Italy.
Abstract
OBJECTIVES: To determine the efficacy of hybrid external fixation in the treatment of tibial pilon fractures. DESIGN: Retrospective, multicentre study. PATIENTS/PARTICIPANTS: Adult patients with tibial pilon fractures treated with hybrid external fixation. INTERVENTION: Fracture reduction with ligamentotaxis and fixation with XCaliber hybrid external fixator. MAIN OUTCOME MEASUREMENTS: Fracture union, complications, functional outcome (Mazur Ankle Score). RESULTS: Union was obtained in 159 fractures at an average of 125days; there were three delayed unions and three non-unions. The most frequent complication was superficial pin-track infections (48), all of which responded to local wound care and antibiotics. There were no deep infections and no DVT. Only one fracture had loss of reduction that required frame revision. The overall functional scores were 91 (excellent) for AO/OTA type A fractures, 89 (good) for type B fractures, and 75 (satisfactory) for type C fractures. CONCLUSIONS: Hybrid external fixation is an effective method of stabilising tibial pilon fractures, particularly those with marked comminution. The minimally-invasive technique and stable fixation enable early mobilisation, with good functional results and minimal complications. LEVEL OF EVIDENCE: Level IV Case series.
OBJECTIVES: To determine the efficacy of hybrid external fixation in the treatment of tibial pilon fractures. DESIGN: Retrospective, multicentre study. PATIENTS/PARTICIPANTS: Adult patients with tibial pilon fractures treated with hybrid external fixation. INTERVENTION: Fracture reduction with ligamentotaxis and fixation with XCaliber hybrid external fixator. MAIN OUTCOME MEASUREMENTS: Fracture union, complications, functional outcome (Mazur Ankle Score). RESULTS: Union was obtained in 159 fractures at an average of 125days; there were three delayed unions and three non-unions. The most frequent complication was superficial pin-track infections (48), all of which responded to local wound care and antibiotics. There were no deep infections and no DVT. Only one fracture had loss of reduction that required frame revision. The overall functional scores were 91 (excellent) for AO/OTA type A fractures, 89 (good) for type B fractures, and 75 (satisfactory) for type C fractures. CONCLUSIONS: Hybrid external fixation is an effective method of stabilising tibial pilon fractures, particularly those with marked comminution. The minimally-invasive technique and stable fixation enable early mobilisation, with good functional results and minimal complications. LEVEL OF EVIDENCE: Level IV Case series.
Authors: Olivia Mair; Patrick Pflüger; Kai Hoffeld; Karl F Braun; Chlodwig Kirchhoff; Peter Biberthaler; Moritz Crönlein Journal: Front Surg Date: 2021-12-23