Fracture reduction and primary ankle arthrodesis: a reliable approach for severely comminuted tibial pilon fracture.

Background: Posttraumatic arthritis and prolonged recovery are typical after a severely comminuted tibial pilon fracture, and ankle arthrodesis is a common salvage procedure. However, few reports discuss the option of immediate arthrodesis, which may be a potentially viable approach to accelerate overall recovery in patients with severe fracture patterns.

Questions/purposes: (1) How long does it take the fracture to heal and the arthrodesis to fuse when primary ankle arthrodesis is a component of initial fracture management? (2) How do these patients fare clinically in terms of modified American Orthopaedic Foot and Ankle Society (AOFAS) scores and activity levels after this treatment? (3) Does primary ankle arthrodesis heal in an acceptable position when anterior ankle arthrodesis plates are used?

Methods: During a 2-year period, we performed open fracture reduction and internal fixation in 63 patients.

Dynamic fixation of distal femur fractures using far cortical locking screws: a prospective observational study.

Objectives: Document fixation and healing of distal femur fractures stabilized by plate osteosynthesis using far cortical locking (FCL) screws.

Design: Prospective and observational.

Setting: Two level 1 and 1 level 2 trauma centers.

Distal tibial varus.

We recommend gradual correction of distal tibia varus as most applicable for patients with severe deformities that would not be adequately corrected with acute methods. Complex deformity, compromised soft tissues, and limb shortening are, in general, better managed with this technique.

Ankle arthrodesis.

Numerous techniques for ankle arthrodesis have been reported since the original description of compression arthrodesis. From the early 1950s to the mid 1970s, external fixation was the dominant technique utilized. In the late 1970s and 1980s, internal fixation techniques for ankle arthrodesis were developed.

The basics of ring external fixator application and care.

The advantages of ring external fixation for correction of complex deformities of the foot and ankle include the ability to correct severe deformity, perform gradual correction, modify treatment during correction, and minimize neurovascular damage. External fixation can provide opportunities to operate on scarred and contracted tissues, preserve joints and joint function, maintain or gain foot length, and allow weight bearing during treatment.

A case report of a severe musculoskeletal injury in a wheelchair user caused by an incorrect wheelchair ramp design.

The Americans with Disabilities Act (ADA) gives all Americans with disabilities a chance to achieve the same quality of life that individuals without disabilities enjoy. In this case report, we will be discussing the consequences of having inaccessible ramps to persons with disabilities that can result in severe musculoskeletal injuries in a wheelchair user. While going down an inaccessible ramp in the garage of a hospital, a wheelchair tipped over, causing a fracture to the user's right femur.

External fixation for distraction osteogenesis.

Distraction osteogenesis methods are indicated in cases of deformity when alternative surgery is not able to produce adequate anatomic restoration and functionality of the foot and ankle. Recent advances in deformity evaluation and techniques of correction may encourage a greater number of surgeons to incorporate distraction osteogenesis into their treatment of complex foot and ankle problems.