Tibial pilon fractures are challenging to treat, as they are typically intra-articular and associated with extensive soft tissue damage. We briefly review the anatomy of the distal tibia, as well as the pathophysiology of pilon fractures. The treatment of tibial pilon fractures is still controversial in the literature, and we present some of the available options. Consideration is also given to peri-operative complications, such as preoperative oedema and blistering and late postoperative traumatic arthritis. Finally, we propose a treatment algorithm (used in our institution), taking into account the level of associated soft tissue injuries. The use of a 2-phase treatment protocol is recommended; however, to date, no absolute treatment protocol exists for these injuries.
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Foot Ankle Surg
January 2025
Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL, United States.
Background: Traumatic peroneal tendon dislocation (PTD) is known to occur with pilon and calcaneus fractures, however, literature describing PTD in concurrence with injury to the talus remains limited.
Methods: This was a retrospective review of adult patients with operatively treated talus fractures treated at a level I academic trauma center between 2007 and 2021. Charts, radiographs, and advanced imaging, when available, were reviewed for patient demographics, injury characteristics, and complications.
Arch Orthop Trauma Surg
January 2025
Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
Introduction: Ankle fractures represent a significant portion of orthopedic injuries, with fracture dislocations tending to have worse outcomes. Logsplitter fractures represent a subset of fracture dislocations in which the talus is axially wedged in the tibiofibular joint. We aim to comprehensively investigate and report on the complications and functional outcomes associated with ankle fracture-dislocations.
View Article and Find Full Text PDFMil Med
January 2025
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
Introduction: As illustrated by the "Walker Dip," there is growing concern regarding the lack of combat casualty care during peacetime. Surgical volume and case complexity are paramount for training and skill sustainment. We sought to quantify the recent orthopedic trauma surgical case load of all military orthopedic surgeons across the Military Health System (MHS).
View Article and Find Full Text PDFJ Orthop Trauma
January 2025
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA.
Objectives: To describe and enumerate surgeries for patients who underwent reconstruction or amputation after severe distal tibia, ankle, and mid to hindfoot injuries.
Methods: Design: Secondary analysis of a multicenter prospective observational study.
Setting: 31 U.
J Biomech
November 2024
Department of Orthopedics and Rehabilitation, The University of Iowa, United States; Department of Biomedical Engineering, The University of Iowa, United States; Department of Industrial and Systems Engineering, The University of Iowa, United States.
A CT-based method for objectively assessing fracture severity was previously developed and validated to address poor reliability in existing subjective fracture classification systems. The method involved quantifying the energy involved in creating a fracture. However, clinical utility of the method was hindered by reliance upon an intact contralateral CT and lengthy analysis time (8-10 h).
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