Journal
FOOT & ANKLE INTERNATIONAL
Volume 42, Issue 6, Pages 723-733Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/1071100720979976
Keywords
open fracture; tibial plafond; plafond fracture; circular external fixator; nonunion; deep infection; amputation
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The use of CEFs in treating open tibial plafond fractures resulted in a high union rate and reduced occurrence of severe complications. However, there were variations in final radiographic alignment.
Background: Open tibial plafond fractures (Orthopaedic Trauma Association and AO Foundation [OTA/AO] 43) are associated with severe complications, including deep infection (closed fractures, 20%; open fractures, 30%), amputation (3%-14%), and nonunion (up to 25%). Circular external fixators (CEFs) can minimize soft tissue injury. This study aimed to report the rate of union and occurrence of severe complications in patients with open tibial plafond fractures treated with CEFs. Methods: A retrospective review of case series was conducted at 3 level I trauma centers. The study included patients older than 18 years with open tibial plafond fractures treated with CEFs. The reported outcomes included union rate, deep infection, operative complications, and limb alignment. The radiographic measurements of anatomic alignment were obtained. Fifty-two patients were included in the study. Results: The primary union rate was 79%. No deep infection occurred in the majority (92%) of patients. No patient required amputation of the affected limb or free flap coverage. Conclusion: Definitive fixation of open tibial plafond fractures with CEFs avoided severe soft tissue complications but resulted in variation in final radiographic alignment.
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