Early Tibiotalar Arthrodesis via Posterior Approach Using an Inverted Humeral Plate in Tibial Pilon Fractures: Functional and Radiological Outcomes.

IF 2.3 3区 医学 Q2 ORTHOPEDICS Orthopaedics & Traumatology-Surgery & Research Pub Date : 2025-02-06 DOI:10.1016/j.otsr.2025.104183
Ramy Samargandi, Maxime Saad, Geoffroy Dubois de Mont-Marin, Louis-RoméeLe Nail, Julien Berhouet
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引用次数: 0

Abstract

Introduction: Communitive tibial pilon fractures are complex fractures in which management is controversial and technically challenging, often leading to a high rate of complications and unsatisfactory outcomes.

Objective: The primary objective of this study was to evaluate the union rate of early tibiotalar arthrodesis using an inverted PHILOS® plate via a posterior approach following a severe comminuted tibial pilon fracture.

Materials and methods: A retrospective study including 9 patients who underwent early tibiotalar arthrodesis between January 2015 and August 2020 following severe comminuted tibial pilon fractures. The procedure was performed via a posterior approach and stabilized using a reversed PHILOS® plate after initial temporary stabilization with an external fixator. The minimum follow-up period was 12 months. The study evaluated the union rate of the arthrodesis and associated fracture, as well as the rate of postoperative complications. Functional outcomes were also assessed using the AOFAS score and the Maryland Foot Score (MFS).

Results: At the latest follow-up, eight patients demonstrated consolidation of both the fracture and the tibiotalar arthrodesis. One patient developed an aseptic non-union, requiring revision surgery. No wound or infectious complications were reported. Two patients showed signs of subtalar arthritis. The mean AOFAS score was 66 points (range 51-82), and the MFS averaged 71 points (range 53-84).

Conclusion: Early tibio-talar arthrodesis via the posterior approach appears to be a reliable technique for achieving consolidation in complex comminuted pilon fractures. The alternative use of an inverted PHILOS® humeral plate also represents a mechanically reliable material option compared to other existing fixation systems LEVEL OF EVIDENCE: IV; case series study.

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来源期刊
CiteScore
5.10
自引率
26.10%
发文量
329
审稿时长
12.5 weeks
期刊介绍: Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.
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Early Tibiotalar Arthrodesis via Posterior Approach Using an Inverted Humeral Plate in Tibial Pilon Fractures: Functional and Radiological Outcomes. Risk Factors for Venous Thromboembolism (VTE) Following Anterior Cruciate Ligament (ACL) Reconstruction: A Systematic Review and Meta-Analysis. Evaluating the transfer of surgical skills from simulation on synthetic bone to cadaveric bone osteosynthesis. Visualization of the posteromedial compartment in the knee: Comparison between a posterolateral transseptal approach with a standard anterior transnotch approach when repairing posterior lesions of the medial meniscus. Contents
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