External fixation in pilon tibial fractures: report of 11 patients
Keywords:
FPT- Fractura del pilón tibial. FE- Fijación externa. FA- Fractura abierta.Abstract
Background: fracture of the tibial pilon is a national and international health problem there are conservative techniques to surgical ones for its treatment, and in the last case external fixation is very important.
Objective: to evaluate the use of simultaneous external fixation of the tibia and internal fixation of the fibula.
Methods: an analytic observational study, with a level of evidence III and recommendation grade B was conducted in Manuel Ascunce Domenech hospital in Camaguey city from January 2014 to April 2016. Eleven patients were selected.
Results: male sex, closed fractures and right ankle prevailed. The commonest closed fractures were the grades one and two according to Tscherne H classification. Regarding open fractures grade two prevailed. Type two according to Rüedi TP and Allgöwer classification system were the commonest found. There was statistical significance between initial and final records at two years based on the evaluative scale of Olreud C and Molander H.
Conclusions: simultaneous external fixation of the tibia and internal fixation of the fibula is an effective method to treat tibial pilon fractures.
DeCS: TIBIAL FRACTURES; FRACTURES, OPEN; EXTERNAL FIXATORS; FRACTURE FIXATION, INTERNAL; OBSERVATIONAL STUDY.
Downloads
References
1.Mostofi SB. Who‘s who in Orthopedics. London: Springer; 2005.
2.Egol KA, Koval KJ, Zuckerman JD. Handbook of fractures. 5th ed. Philadelphia: Wolters Kluwer; 2015.
3.Abd-Almageed E, Marwan Y, Esmaeel A, Mallur A, El-Alfy B. Hybrid external fixation for Arbeitsgemeinschaft für Osteosynthesefragen (AO) 43-C tibial plafond fractures. J Foot Ankle Surg. 2015 Nov-Dec;54(6):1031-6.
4.Deivaraju C, Vlasak R, Sadasivan K. Staged treatment of pilon fractures. J Orthop. 2015 Feb;12(Suppl 1):S1-6.
5.Krettek C, Bachmann S. Pilon fractures. Part 1: diagnosis, treatment strategies and approaches. Chirurg. 2015 Jan;86(1):87-101.
6.Osman W, Alaya Z, Kaziz H, Hassini L, Braiki M, Naouar N, et al. Treatment of high-energy pilon fractures using the ILIZAROV treatment. Pan Afr Med J. 2017 Jul 14;27:199.
7.Jacob N, Amin A, Giotakis N, Narayan B, Nayagam S, Trompeter AJ. Management of high-energy tibial pilon fractures. Strategies Trauma Limb Reconstr. 2015 Nov;10(3):137-47.
8.Luo H, Chen L, Liu K, Peng S, Zhang J, Yi Y. Minimally invasive treatment of tibial pilon fractures through arthroscopy and external fixator-assisted reduction. Springerplus. 2016 Nov;5(1):1923.
9.Daghino W, Messina M, Filipponi M, Alessandro M. Temporary stabilization with external fixator in 'tripolar' configuration in two steps treatment of tibial pilon fractures. Open Orthop J. 2016 Mar 30;10:49-55.
10.Stapleton JJ, Zgonis T. Surgical treatment of tibial plafond fractures. Clin Podiatr Med Surg. 2014 Oct;31(4):547-64.
11.Duckworth AD, Jefferies JG, Clement ND, White TO. Type C tibial pilon fractures: short- and long-term outcome following operative intervention. Bone Joint J. 2016 Aug;98-B(8):1106-11.
12.Larraínzar Garijo R, Corella Montoya F, Marín Peña O. Medicina basada en la evidencia y su aplicación a la cirugía Ortopédica y Traumatológica. Trauma Fund MAPFRE. 2010;21 (Supl 1):21-7.
13.Borreli J, Ellis E. Pilon fractures. Assessment and treatment. Orthop Clin North Am. 2002 Jan;33(1):231-45.
14.Olreud C, Molander H. A scoring evaluation after ankle fractures. Arch Orthop Trauma Surg. 1984 Mar;103(3):190-4.
15.Valderrama Molina CO, Estrada Castrillón M, Hincapie JA, Lugo Agudelo LH. Intra-and interobserver agreement on the Oestern and Tscherne classification of soft tissue injury in periarticular lower-limb closed fractures. Colomb Med (Cali). 2014 Dec;45(4):173-8.
16.Gustilo RB, Anderson JT. JSBS classics. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. Retrospective and prospective analyses. J Bone Joint Surg Am. 2002 Apr;84-A(4):682.
17.Rüedi TP, Allgöwer M. The operative treatment of intra-articular fractures of the lower end of the tibia. Clin Orthop Relat Res. 1979 Jan-Feb;(138):105-10.
18.Lavini F, Dall'Oca C, Mezzari S, Maluta T, Luminari E, Perusi F, et al. Temporary bridging external fixation in distal tibial fracture. Injury. 2014 Dec;45 Suppl 6:S58-63.
19.Danoff JR, Saifi C, Goodspeed DC, Reid JS. Outcome of 28 open pilon fractures with injury severity-based fixation. Eur J Orthop Surg Traumatol. 2015 Apr;25(3):569-75.
20.Kilian O, Bündner MS, Horas U, Heiss C, Schnettler R. Long-term results in the surgical treatment of pilon tibial fractures. A retrospective study. Chirurg. 2002 Jan;73(1):65-72.
21.Watson JT, Moed BR, Karges DE, Cramer KE. Pilon fractures. Treatment protocol based on severity of soft tissue injury. Clin Orthop Relat Res. 2000 Jun;(375):78-90.
22.Galante VN, Vicenti G, Corina G, Mori C, Abate A, Picca G, et al. Hybrid external fixation in the treatment of tibial pilon fractures: a retrospective analysis of 162 fractures. Injury. 2016 Oct;47 Suppl 4:S131-S7.
23.Ziran BH, Morrison T, Little J, Hileman B. A new ankle spanning fixator construct for distal tibia fractures: optimizing visualization, minimizing pin problems, and protecting the heel. J Orthop Trauma. 2013 Feb;27(2):e45-9.
24.Japjec M, Staresinic M, Culjak V, Vrgoc G, Sebecic B. The role of external fixation in displaced pilon fractures of distal tibia. Acta Clin Croat. 2013 Dec;52(4):478-84.
25.Lin MS, Lee HM, Hou YT, Shih JT, Tan CM. Treatment of tibial pilon fractures using the Link May Anatomic Bone Plate. J Chin Med Assoc. 2003 Jul;66(7):423-8.
26.Kurylo JC, Datta N, Iskander KN, Tornetta P 3rd. Does the fibula need to be fixed in complex pilon fractures? J Orthop Trauma. 2015 Sep;29(9):424-7.
27.Zhao L, Li Y, Chen A, Zhang Z, Xi J, Yang D. Treatment of type C pilon fractures by external fixator combined with limited open reduction and absorbable internal fixation. Foot Ankle Int. 2013 Apr;34(4):534-42.
28.Hardeski D, Gaski G, Joshi M, Venezia R, Nascone JW, Sciadini MF, et al. Can applied external fixators be sterilized for surgery? A prospective cohort study of orthopaedic trauma patients. Injury. 2016 Dec;47(12):2679-82.
29.Wang Z, Qu W, Liu T, Zhou Z, Zhao Z, Wang D, et al. A two-stage protocol with vacuum sealing drainage for the treatment of type C pilon fractures. J Foot Ankle Surg. 2016 Sep-Oct;55(5):1117-20.
30.Ballal A, Rai HR, Shetty SM, Mathias LJ, Shetty V, Shetty A. A prospective study on functional outcome of internal fixation of tibial pilon fractures with locking plate using minimally invasive plate osteosynthesis technique. J Clin Diagn Res. 2016 Jan;10(1):RC01-4.
31.Vidovic D, Matejcic A, Ivica M, Jurišic D, Elabjer E, Bakota B. Minimally-invasive plate osteosynthesis in distal tibial fractures: Results and complications. Injury. 2015 Nov;46 Suppl 6:S96-9.
32.El-Mowafi H, El-Hawary A, Kandil Y. The management of tibial pilon fractures with the Ilizarov fixator: the role of ankle arthroscopy. Foot (Edinb). 2015 Dec;25(4):238-43.
Published
How to Cite
Issue
Section
License
Copyright: Camagüey Medical Archive Magazine, offers immediately after being indexed in the SciELO Project; Open access to the full text of the articles under the principle of making available and free the research to promote the exchange of global knowledge and contribute to a greater extension, publication, evaluation and extensive use of the articles that can be used without purpose As long as reference is made to the primary source.
Conflicts of interest: authors must declare in a mandatory manner the presence or not of conflicts of interest in relation to the investigation presented.
(Download Statement of potential conflicts of interest)
The Revista Archivo Médico de Camagüey is under a License Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 International (CC BY 4.0).
This license allows others to distribute, to mix, to adjust and to build from its work, even for commercial purposes, as long as it is recognized the authorship of the original creation. This is the most helpful license offered. Recommended for maximum dissemination and use of licensed materials. The full license can be found at: https://creativecommons.org/licenses/
14 julio 2025