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

A Comparative Study to Assess Effectiveness of Hemocoagulase, Tranexamic Acid and a Combination of both in Reducing Perioperative Blood Loss and Transfusion Requirement in Patients Undergoing Major Hip and Femoral Surgeries

Introduction: Major hip and femoral surgeries are often associated with significant blood loss. Aim of this clinical study, was to evaluate the efficacy of intravenous hemocoagulase, tranexamic acid and the combination o...

Assessment of Risk Factors for development of Polycystic Ovarian Syndrome

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder mostly due to hormonal imbalances. There could be more than one predisposing factors that can contribute for development of PCOS. However ther...

Ruptured Ectopic Pregnancy, the Challenges for the Obstetrician: Single Center Prospective Study

Introduction: Ruptured ectopic pregnancy is a life threatening obstetrical emergency and presents in various ways. The aim was to evaluate predisposing factors associated with development of ectopic pregnancy in current...

Solitary Infantile Myofibromatosis at Distal end of Humerus: A Rare Case Report

Introduction: Infantile myofibromatosis is a rare benign disorder of mesenchymal origin presenting as tumors in skin, muscles,bones and soft tissue of head and neck. Its solitary occurrence in bones is very rare. It is e...

Efficacy of Synovial Fluid Analysis in Diagnosing Various Types of Arthritis, with Special Reference to Percutaneous Synovial Biopsy as a Diagnostic Tool

Introduction: Arthritis, a common clinical occurrence of joints, is a very prevalent chronic disease in India and various parts of the world. It is estimated to affect 1% of world’s adult population.Biopsies of Synovial...

Download PDF file
  • EP ID EP432239
  • DOI -
  • Views 123
  • Downloads 0

How To Cite

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 (2018). Open reduction and Internal Fixation (ORIF) of Posterior Pilon Variant Fractures with Buttress Plate Through Posterolateral Approach. International Journal of Contemporary Medical Research, 5(10), 1-5. https://europub.co.uk/articles/-A-432239