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- IRMS - Nicolae Testemitanu SUMPh
- 1. COLECȚIA INSTITUȚIONALĂ
- MedEspera: International Medical Congress for Students and Young Doctors
- MedEspera 2020
Please use this identifier to cite or link to this item:
http://hdl.handle.net/20.500.12710/12289
Title: | The two-stage surgical treatment vs primary internal fixation of pilon fractures |
Authors: | Guzun, Andrei |
Keywords: | Pilon fracture;Open reduction internal fixation;Two-stage surgery |
Issue Date: | 2020 |
Publisher: | MedEspera |
Citation: | GUZUN, Andrei. The two-stage surgical treatment vs primary internal fixation of pilon fractures. In: MedEspera: the 8th Internat. Medical Congress for Students and Young Doctors: abstract book. Chișinău: S. n., 2020, pp. 111-112. ISBN 978-9975-151-11-5. |
Abstract: | Introduction. Tibial pilon fractures are severe injuries to the distal articular surface of the tibia
and, although described for more than a hundred years, remain to be a challenge for the
orthopedic surgeon, since it involves obtaining an anatomical reduction of the articular surface
and an adequate management of the soft tissues, the lesions of which the most often dictate
treatment options. Various treatment methods are available, depending not only on the fracture
type but mostly on the extent of the soft tissue injury. Most frequent procedure is a two-stage
surgery: the initial closed reduction of the fracture via primary placement of an ankle jointspanning
external fixator, if possible in conjunction with open reduction and internal fixation
of the fractured fibula followed by a secondary procedure after soft tissue recovery by open
reduction and internal fixation of the tibial pilon. The new types of low-profile and locking
plates available for internal fixation can allow the anatomical reconstruction of the fractured
articular surface in a single stage.
Aim of the study. This study was performed to analyse the results of staged treatment protocol
and the primary internal fixation for treating distal tibial fractures.
Materials and methods. A literature search was performed using PubMed. The combination
of words “tibial pilon fractures staged treatment AND primary fixation” has been used for
searching.
Results. 21 articles were obtained as a result of the search. Six articles were excluded due to
content (articles about primary arthrodesis, lymphedema and external fixator). Of the 15
articles included in the study, in 7 articles were presented the results of surgical treatment of
pilon fractures in two stages, in 4 articles the results of the primary fixation and in 4 articles
the comparative results of these two methods. In the studies the rate of infection (superficial
or deep infection, osteomyelitis), malunion, nonunion, duration of hospital stay, neurovascular
injury, pain intensity and patients' satisfaction with AOFAS score were compared between the
two groups. There was no significant difference between the groups in measured variables
except hospital stay which was significantly longer for the two-stage group. O’White, Carter,
Duckworth and the co-authors recommend to treat definitely a patient with pilon fractures type
C and Tscherne 1, 2 in one stage ORIF during the first 24 hours after the injury.
Conclusions. Recent studies demonstrate low complications with early definitive fixation of
pilon fractures type C (AO/OTA). However, the overall prognosis for these injuries often
remains poor. |
URI: | https://medespera.asr.md/wp-content/uploads/ABSTRACT-BOOK.pdf http://repository.usmf.md/handle/20.500.12710/12289 |
ISBN: | 978-9975-151-11-5. |
Appears in Collections: | MedEspera 2020
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