The Journal of Bone and Joint Surgery, Vol 77, Issue 10 1498-1509, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Use of an articulated external fixator for fractures of the tibial plafond
JL Marsh, S Bonar, JV Nepola, TA Decoster and SR Hurwitz
Department of Orthopaedics, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
We performed a prospective study of forty-nine displaced fractures of the
tibial plafond in forty-eight patients managed, at three centers, with an
articulated external fixator placed medially across the ankle joint. Forty
ankles had interfragmental screw fixation of a reduced articular fracture,
and fourteen ankles had bone-grafting. The average duration of external
fixation was twelve weeks. All of the fractures healed (one after delayed
bone-grafting). There were no infections in any of the operative or
traumatic wounds over the tibia. Two wound infections over the fibula
resolved with treatment. Eight patients were managed with antibiotics for a
pin-site infection, and two patients had curettage and debridement of a pin
site in the hindfoot after removal of the fixator. Thirty patients
(thirty-one ankles) completed two-year data sheets at an average of thirty
months after the injury. The average ankle score was 67 points. Twenty-one
patients had grade-0 or 1 osteoarthrosis and nine had grade-2 or 3. One
ankle had been treated with an arthrodesis. These data suggest that the
prevalence of early complications associated with severe fractures of the
tibial plafond and their treatment can be decreased with use of an
articulated external fixator combined with limited internal fixation. We
concluded that this technique of external fixation is a satisfactory
technique for the treatment of these fractures.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
