Minimally invasive treatment of pilon fractures with a low profile plate: preliminary results in 17 cases

Détails

ID Serval
serval:BIB_F7E1BC73AFF7
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Minimally invasive treatment of pilon fractures with a low profile plate: preliminary results in 17 cases
Périodique
Archives of Orthopaedic and Trauma Surgery
Auteur(s)
Borens  O., Kloen  P., Richmond  J., Roederer  G., Levine  D. S., Helfet  D. L.
ISSN
0936-8051 (Print)
Statut éditorial
Publié
Date de publication
2006
Notes
DA - 20060904
LA - ENG
PT - JOURNAL ARTICLE
Résumé
OBJECTIVE: To determine the results of "biologic fixation" with a minimally invasive plating technique using a newly designed low profile "Scallop" plate in the treatment of pilon fractures. DESIGN: Retrospective case series. SETTING: A tertiary referral center. PATIENTS/PARTICIPANTS: Seventeen patients were treated between 1999 and 2001 for a tibial plafond fracture at the Hospital for Special Surgery with a newly designed low-profile plate. Eleven of the fractures (65%) were high-energy injuries. Two fractures were open. INTERVENTION: Staged surgical treatment with open reduction and fixation of the fibular fracture and application of an external fixator was performed in 12 cases. As soon as the soft tissues and swelling allowed, i.e. skin wrinkling, the articular surface was reconstructed and simply reduced, if necessary through an small incision, and the articular block was fixed to the diaphysis using a medially placed, percutaneously introduced flat scallop plate. In the remaining five cases the operation was performed in one session. MAIN OUTCOME MEASUREMENTS: Time to healing and complications including delayed union, non-union, instrument failure, loss of fixation, infection, quality of reduction and number of reoperations were evaluated. Quality of results and outcome were graded using the ankle-hindfoot-scale and a modified rating system. RESULTS: All patients went on to bony union at an average time of 14 weeks. There were no plate failures or loss of fixation/reduction. Two superficial wound-healing problems resolved with local wound care. At an average follow up of 17 months (range 6-29 months) eight patients (47%) had an excellent result; seven (41%) had a fair result whereas two (12%) had a poor result. The average ankle-hindfoot-score was 86.1 (range 61-100). Four patients have had the hardware removed and one of them is awaiting an ankle arthrodesis. CONCLUSIONS: Based on these initial results, it appears that a minimally invasive surgical technique including new low profile plate can decrease soft tissue problems while leading to fracture healing and obtaining results comparable with other more recent series. We believe that this new "Scallop Plate" is effective for the treatment of pilon fractures and should be used in conjunction with a staged procedure in the acute trauma setting
Mots-clé
Fracture Healing/injuries/surgery
Pubmed
Web of science
Création de la notice
25/02/2008 13:59
Dernière modification de la notice
03/03/2018 22:51
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