Abstract
The pilon fracture is a complex injury. The purpose of this study was to evaluate the outcome of minimally invasive techniques in management of these injuries. This was a prospective study of closed AO type C2 and C3 fractures managed by early (<36 hours) minimally invasive surgical intervention and physiotherapist led rehabilitation. Thirty patients with 32 intra-articular distal tibial fractures were treated by the senior surgeon (GK). Our aim was to record the outcome and all complications with a minimum two year follow-up. There were two superficial wound infections. One patient developed a non-union which required a formal open procedure. Another patient was symptomatic from a palpable plate inferiorly. An excellent AOFAS result was obtained in 83% (20/24) of the patients. Early minimally invasive reduction and fixation of complex high velocity pilon fractures gave very satisfactory results at a minimum of two years follow-up.
Résumé
Les fractures du pilon tibial sont toujours des fractures avec traumatisme complexe. Le but de cette étude est d’évaluer le devenir du traitement de ces fractures après utilisation de techniques dites mini-invasives. Matériel et méthode: une étude prospective portant sur des fractures de ce type fermées C2 et C3 dans la classification AO et traitées précocement (moins de 36 heures après le traumatisme) ont été inclues dans cette étude avec abord mini-invasif et rééducation rapide. 30 patients présentaient 32 fractures intra-articulaires, les patients ayant été traités par un chirurgien senior (GK). Le suivi de cette étude est de rapporter les complications et le devenir avec un suivi minimum de deux ans. Résultats, il faut déplorer deux infections superficielles, un patient présentant une pseudarthrose nécessitant un nouveau traitement chirurgical, un patient présentait des douleurs symptomatiques au niveau de la partie inférieure de la plaque d’ostéosynthèse. Un résultat excellent selon les critères de l’AOFAS a été obtenu dans 83% des cas (20/24). Conclusion: une réduction précoce par technique mini-invasive avec fixation permet d’avoir des résultats satisfaisants après un suivi minimum de deux ans dans ces fractures graves du pilon tibial.
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Leonard, M., Magill, P. & Khayyat, G. Minimally-invasive treatment of high velocity intra-articular fractures of the distal tibia. International Orthopaedics (SICOT) 33, 1149–1153 (2009). https://doi.org/10.1007/s00264-008-0629-5
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DOI: https://doi.org/10.1007/s00264-008-0629-5