Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation
Cisneros, Luis Natera (Hospital General de Catalunya)
Gómez, Mireia (Institut d'Investigació Biomèdica Sant Pau)
Alvarez, Carlos (Hospital Cima (Barcelona))
Millán, Angélica (Institut d'Investigació Biomèdica Sant Pau)
De Caso, Julio (Institut d'Investigació Biomèdica Sant Pau)
Soria, Laura (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona. Departament de Cirurgia

Date:	2016
Abstract:	Tibial platfond fractures are usually associated with massive swelling of the foot and ankle, as well as with open wounds. This swelling may cause significant decrease of the blood flow, so the state of the soft tissue is determinant for the surgical indication and the type of implant. This retrospective study compares the union times in cases of tibial plafond fractures managed with a hybrid external fixation as a definitive procedure versus those managed with a two stage strategy with final plate fixation. A retrospective study in a polytrauma referral hospital was performed between 2005 and 2011. Patients with a tibial plafond fracture, managed with a hybrid external fixation as a definitive procedure or managed with a two stage strategy with the final plate fixation were included in the study. Postoperative radiographs were evaluated by two senior surgeons. Fracture healing was defined as callus bridging of one cortex, seen on both lateral and anteroposterior X-ray. The clinical outcome was evaluated by means of 11 points Numerical Rating Scale for pain and The American Orthopedic Foot and Ankle Society ankle score, assessed at the last followup visit. Thirteen patients had been managed with a hybrid external fixation and 18 with a two-stage strategy with the final plate fixation. There were 14 males and 17 females with a mean age of 48 years (range 19-82 years). The mean followup was 24 months (range 24-70 months). The mean time from surgery to weight bearing was 7 ± 6. 36 days for the hybrid fixation group and 57. 43 ± 15. 46 days for the plate fixation group (P 0. 0001); and the mean time from fracture to radiological union was 133. 82 ± 37. 83) and 152. 8 ± 72. 33 days respectively (P = 0. 560). Besides the differences between groups regarding the baseline characteristics of patients, the results of this study suggest that in cases of tibial plafond fractures, the management with a hybrid external fixation as a definitive procedure might involve a faster union than a two-stage management with final plate fixation.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials i que es distribueixin sota la mateixa llicència que regula l'obra original. Cal que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; Versió publicada
Subject:	Fracture healing ; Hybrid external fixation ; Polyaxial locking plates ; Tibial plafond fractures ; Tibial fracture ; Fracture fixation ; Orthopedic fixation devices
Published in:	Indian Journal of Orthopaedics, Vol. 50 (2016) , p. 123-130, ISSN 1998-3727

DOI: 10.4103/0019-5413.177577
PMID: 27053800

14 p, 332.7 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Published articles