Significance of external fixator in multi-staged management of high energy Pilon fracture
- VernacularTitle:外固定支架在高能量Pilon骨折分期治疗中的地位和意义探讨
- Author:
Kanda GAO
;
Jie TAO
;
Qiugen WANG
- Publication Type:Journal Article
- Keywords:
external fixator;
Pilon fracture;
multi-staged management
- From:
Orthopedic Journal of China
2006;0(12):-
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]Pilon fractures are often high-energy injuries.One third to half of these fractures are companied by other fractures or organs injuries.10%~30% Pilon injuries are open fractures.This study was aimed to evaluate the significance of external fixator in the multi-staged management of Pilon fractures.[Method]Ten patients(M=8,F=2) with high-energy Pilon fractures were managed from February 2004 to March 2007.Their average age was 56.2 yrs(range 22 to 72 yrs).All patients underwent external fixation of single-arm external fixator(Orthofix)or Hoffmann external fixator-II(Stryker) in the very early stage.Then it was replaced by strong internal fixation through open reduction or close reduction with the technique of minimally invasive percutaneous plate oesteosynthesis(MIPPO) when general conditions were controlled,the wound surface healed and the soft tissues improved.[Result]The mean duration of external fixation was 13.2 days(range 7-49 days).All the external fixations were changed to internal fixations.All the traumatic and operative wounds healed.All bone fractures united.No compartment syndrome or osteomyelitis occurred in this study.One case of open Pilon fracture was found infection after external fixation.It was changed to internal plate fixation after 7 weeks of anti-infection treatment.The infection was controlled and the bone reunited.[Conclusion]For high-energy Pilon fractures,multi-staged management,including correct evaluation of local soft tissue injuries and general conditions,proper damage control via external fixator,and right timing to change to internal fixator,is safe and effective.
