Preoperative planning and application of minimally traumatic surgical technique in pilon fractures

Authors

  • Grygorii Bets
  • Ivan Stoyko
  • Iryna Bets

DOI:

https://doi.org/10.15674/0030-59872013430-34

Keywords:

pilon fractures, surgery, preoperative planning, plate osteosynthesis, extrafocal osteosynthesis, repositional osteosynthesis

Abstract

It is known that in high-energy injuries with resultant pilon fractures the damaged tissues are usually on the brink of viability. The standard of surgical treatment today consists in plate osteosynthesis with wide surgical approaches and use of massive hardware. As result of the above, the limit of viability of the investing tissues often turns to be overstepped and irreversible necrotic suppurative complications develop, reaching 54 %. The purpose of the present work was to find the alternative minimally traumatic tactics during preoperative planning for surgical treatment of pilon fractures with combined use of distraction ligamentotaxis with help of rod devices and reposition osteosynthesis. Absence of prognostically significant necrotic suppurative complications and achievement of acceptable results of bone fragment reposition became the first result of using the suggested tactics in 34 patients with pilon injuries.

References

  1. Guide internal osteosynthesis / M. E. Muller, M. Allgover, R. Schneider, H. Vellinger. — Springer-Verlag: Ad Marginem, 1996. — 586 р.
  2. Dirschi D. R. Reliability of classification of fractures of the tibial plafond according to a rank — order method / D. R. Dirsch, S. T. Ferry // J. Trauma. — 2006. — Vol. 61, № 6. — Р. 1463–1466.
  3. Orcu G. Intraаrticular fractures of the tibial plafond: a compression of the results using articulated and ring external fixators / G. Orcu, K. Artuglu // J. Bone Joint Surg. — 2004. — Vol. 86-B. — P. 868–875.
  4. Thordarson D. B. Complication after treatment of tibial pilon fractures and management strategies / D. B. Thordarson // J. Am. Acad. Orthop. Surg. — 2000. — Vol. 8, № 4. — P. 253–265.
  5. Ankin L. N. Trauma. The European standards / L. N. Ankin, N. L. Ankin. — Moscow, 2005. — Р. 432–438.
  6. Aeberhard H. J. Der Einfluss der Platten — Uberbie gung auf die Torsionsstibilitat der Ostheosintese / H. J. Aeberhard: Inaugural dissertation, University of Bern, 1973.
  7. The dynamiccompression plate / M. Allgover, P. Mattex, S. M. Perren, T. Ruedi. — Springer, Berlin Heidelberg New York., 1973. — 687 р.
  8. Trufanov I. I. Comprehensive treatment of intra-articular fractures of the distal tibial / I. I. Trufanov // Actual problems of medical science and practice of: Zaporizhzhya, 2008. — [Proceedings of ZMAPO]. — Р. 213–217.
  9. Pobel A. N. Location pilon fracture fragments and their choice of method comparison and retention. / A. N. Pobel, I. I. Trufanov, V. S. Gotsak // Orthopedics, traumatology and prosthetics. — № 3 — 2011. — P. 111–116.

How to Cite

Bets, G., Stoyko, I., & Bets, I. (2014). Preoperative planning and application of minimally traumatic surgical technique in pilon fractures. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (4), 30–34. https://doi.org/10.15674/0030-59872013430-34

Issue

Section

ORIGINAL ARTICLES