Open reduction and Internal Fixation (ORIF) of Posterior Pilon Variant Fractures with Buttress Plate Through Posterolateral Approach
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 10
Abstract
Introduction: Pilon fractures are major group of fractures around the ankle which involves the lower end of tibia bone that forms the ankle joint by articulating with the talus. It is also known as plafond fractures. Posterior pilon variant fracture is characterized by the involvement of both posterolateral and posteromedial malleolar fragment. The aim of this study was to assess the outcome using posterolateral surgical approach in posterior tibial pilon variant fracture using buttress plate. Material and Methods: The study was conducted for the duration of 2 years from September 1, 2013 to December 31, 2015, 110 consecutive patients with ankle fractures underwent operative treatment at The first affiliated hospital of Zhengzhou University. It was found that 13 fractures in 13 patients with impaction of the posterior tibial plafond were identified as posterior pilon fractures with the help of CT scans and the treatment was done through posterolateral approach with buttress plating. The follow-up was done for all the 13 patients. The clinical outcome was measured with the American Orthopaedic Foot and Ankle Society score (AOFAS) and the visual analogue scale (VAS). The radiological evaluation was done using the osteoarthritis score (OAscore). Results: All the 13 patients were found with satisfactory and stable fixation. At a mean follow up of 18.5 months, all the patients had good radiological results and showed satisfactory clinical outcome. The mean AOFAS was 90.38, the mean OA - Score was 0.4 and the mean VAS score during, rest, active motion, and weights bearing walking were 0.4, 0.5, and 1.0 respectively. All the fractures were healed and there was no skin breakdown, malunion or delayed union. Accurate reduction was achieved in all patients. No wound complication or hardware irritation was found. No nerve injury was reported in any patients intra-operatively. Conclusion: Surgeons should be able to handle and treat the soft tissue injury with extra care. No single method of fixation is ideal for all pilon fractures, or suitable for all patients. In the present study, it was found that open reduction and internal fixation of posterior variant pilon fracture with buttress plate through posterolateral approach is a good alternative to the anteromedial approach, if the fracture type is appropriate to use this approach. Buttress plating provides rigid fixation allowing early postoperative mobilisation in patients. Posterolateral approach is safe with satisfactory wound healing without any complications.
Authors and Affiliations
Atul Dwivedi, Shweta Shukla Dwivedi, Su Zhenhong, Si Wenxia, Yuan Chao, Li Duanzhuo, Huang Mi, Yu Xin, Sarbesh Kumar Jha, Deepak sigdel, Praveen kumar, Nagendra Prasad Yadav
Keywords
Related Articles
- EP ID EP432239
- DOI -
- Views 97
- Downloads 0
A Case of Primary Amenorrhea Presenting with Hypokalemic Paresis and Hypertension
Introduction: 17α hydroxylase deficiency, an autosomal recessive disorder is a rare cause of Congenital Adrenal Hyperplasia (CAH) with an estimated incidence of around 1 in 70,000. Only a very few cases have been reporte...
A Randomized Control Trial Comparing Propofol with Midazolam and Fentanyl Combination for Sedation in Gastrointestinal Endoscopies
Introduction: Propofol can be easily titrated and has a rapid recovery profile, thus has revolutionised sedation practices in gastrointestinal (GI) endoscopy. The objective of this study was to compare efficacy and safet...
Morphological Variations of the Human Suprascapular Notch in the Rayalseema Zone of South India and its Surgical Implications
Introduction: Suprascapular notch is present at the lateral end of the upper border of the scapula close to the root of the coracoid process. Six different morphological variations have been described for the notch in th...
Study of Microalbuminuria Level in Chronic Complications of type 2 Diabetes
Introduction: Microalbuminuria occurs when kidney leaks a minute amount of albumin in urine or when there is an abnormally increase in permeability for albumin in the renal glomerulus. It is a strong risk factor of cardi...
Cytological Analysis of Pleural Effusion - A Five Year Retrospective Study
Introduction: Cytological examination of pleural fluid is considered less invasive than biopsy, more simple, inexpensive, allows faster diagnosis and it facilitates in cancer screening in some cases. Cytological examinat...