Can One Treat Pilon Fracture In Conjunction With Accurate Osseous Reduction And Rigid Fixation By Ilizarov And Assisted Arthroscopic Reduction?

Faculty Medicine Year: 2015
Type of Publication: ZU Hosted Pages: 12
Authors:
Journal: ansoura Engineering Journal(MEJ), Faculty of Engineering Life Science Journal 2015;12(1) Volume: 1110-0141
Keywords : , , Treat Pilon Fracture , Conjunction With Accurate    
Abstract:
Abstract: Introduction: Anatomic restoration of the joint is the goal of management in fractures about the ankle. Open surgical treatment of comminuted tibialPilon fractures is associated with substantial complications in many patients. Indirect reduction and stabilization of fractures by means of distraction using a circular external fixator and anatomic repositioning of the joint surface assisted by arthroscopy can be a useful method of achieving satisfactory joint restoration. The potential benefits are less extensive exposure, preservation of blood supply, and improved visualization of the pathology. Patient and methods: This was a prospective study conducted between October 2010 and, September 2013 on twelve patients were presented to the emergency department of Zagazig university hospitals with high energy distal tibial fractures of closed and Gustilo Types I&II open fractures. All cases were treated using Ilizarov fixators with or without limited internal fixation and assessment of intra-articular reduction of tibial plafond by arthroscopy. All had been allowed to bear partial weight on the limb in the early postoperative period. A follow up review ranged from12 to 18 months(mean 15 months). Results: All cases had united with a mean time of 13.75 weeks (range from 8 to 19), good range of motion was achieved in most at the end of the follow up period. According to the adopted score for evaluation of this series, four cases were excellent, five cases were good, and threecases were faire. Conclusions: Application of the principles of capsuloligamentotaxis by means of circular external fixation combined with Anatomical repositioning of the joint surface assisted by Arthroscopy is a wonderful tool in the management of intra-articular fractures of tibial plafond. It assists in attaining anatomical reduction while minimizing disruption of the soft tissue envelopeand early mobilization of the joint.
   
     
 
       

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