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BMC Musculoskeletal Disorders

, 17:328

Orthopedics and biomechanics

Abstract

BackgroundPosterior pilon variant fracture is a recently described posterior malleolus fracture characterized by the involvement of both posterolateral and posteromedial malleolar fragment. The associated surgical approach remains controversial. The aim of this study was to present the application of modified posteromedial approach in the treatment for posterior pilon variant fracture.

MethodsSixteen patients were identified with posterior pilon variant fractures. All fractures were operated via modified posteromedial approach. Fragment length ratio, area ratio and height were measured as morphologic assessments. The clinical outcome was evaluated with American Orthopaedic Foot and Ankle Society ankle-hind foot score and visual analogue scale. Radiological images were evaluated using osteoarthritis-score.

ResultsAccording to the radiological measurements, the average fragment length ratio of posteromedial and posterolateral fragment was 25.3 and 31.5 % respectively. All fractures healed within a mean period of 13.1 weeks without malalignment or articular step-off. Fourteen patients were followed up, and all achieved good or excellent ankle function. The average score of American Orthopaedic Foot and Ankle Society and visual analogue scale at rest, motion and weight bearing walking was 85.6 and 0.25, 0.81, 1.31 respectively.

ConclusionModified posteromedial approach provides an alternative surgical treatment for posterior pilon variant fractures, and the short-term outcome was good.

KeywordsAnkle fractures Posterior pilon Posterior malleolus Posteromedial approach Posterolateral approach Tibial plafond Electronic supplementary materialThe online version of this article doi:10.1186-s12891-016-1182-9 contains supplementary material, which is available to authorized users.

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Autor: Yukai Wang - Jianwei Wang - Cong feng Luo

Fuente: https://link.springer.com/







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