![]() Currently two methods are gaining popularity. The classic ORIF with buttress plating became more and more replaced with other methods of fixation. 6 This led to a change of the philosophy of treating such injuries with more respect to the soft tissues and a tailored management of different fracture types. 4,5 This was mainly attributed to lack of appreciation of the damage to the soft tissues, and on the other hand attempting to apply the principles of ORIF to all types of pilon fractures without discrimination. However, their impressive results were not paralleled by other authors and subsequent reports showed a significant number of major complications. Ruedi and Allgower 3 popularized open reduction and internal fixation (ORIF) for these fractures and established treatment guidelines. Numerous classifications have been proposed for these fractures, however, the AO-OTA alphanumeric classification 1,2is the most comprehensive as well as the most commonly quoted classification. The involvement of the ankle joint and the vulnerability of the surrounding soft tissues further complicate these already complex injuries. Introductionįractures of the tibial plafond are rare injuries that present a challenge as to their best method of management. Conclusion Minimally invasive plate osteosynthesis is a good and safe technique for treatment of distal tibial fractures without intra-articular comminution providing fracture healing, rapid functional recovery, and avoidance of major complications. ![]() Two patients had a superficial wound infection, 2 patients complained of prominence of the plate, and two patients had radiological evidence of degenerative changes in the ankle. Twelve patients (71%) had excellent or good results. Seven patients (40%) were pain-free, 5 patients (30%) had pain after stressful activities, 3 patients (18%) had mild to moderate pain requiring analgesics, one patient (6%) had moderate pain causing restriction of activities, and one patient (6%) had continuous pain. Results All fractures united at an average of 13 weeks. Two patients had a grade I open fracture. Seven patients had associated skeletal injuries. Patients and methods Seventeen patients with tibial pilon fractures were treated by MIPO using an anatomical distal tibial plate. Minimally invasive plate osteosynthesis (MIPO) is becoming a popular method of treating these injuries when there is no articular comminution and the soft tissue envelope is minimally disturbed. ![]() Levels of Evidence: Level IV: Case series, Clinical research.Īnkle fracture calcaneus fracture hallux valgus hallux valgus correction pilon fracture podiatry surgical volume total ankle replacement.Background Fractures of the tibial plafond are rare injuries that present a challenge as to their best method of management. ![]() Our study showed the trends in surgical volumes and differences between surgical podiatrists and orthopaedic surgeons and the evolution of these volumes over a ten year period and differences in surgical repertoire between orthopaedists and podiatrists. On the other hand, our study showed that podiatrists perform almost 9 out of 10 hallux valgus correction surgeries. Orthopaedic surgeons are the main treating surgeon for common foot and ankle traumatic conditions or complex hind foot cases like TAR. We found that the number of foot and ankle procedures performed annually is steadily increasing. We recorded the timing and nature of procedures along with various features associated with the surgeon and the geographic location of the treatment facility. We searched current procedural terminology (CPT) codes for total ankle replacement (TAR), triple arthrodesis, hallux valgus correction, pilon fracture open reduction and internal fixation (ORIF), calcaneus fracture ORIF, and ankle fracture ORIF. With the trend in healthcare now placing increased emphasis on quality and standardizing patient care, this study aimed to characterize the distribution, volume, and trends of certain foot and ankle surgeries performed in the US by both orthopaedic surgeons and podiatrists.Ī retrospective analysis was performed using the Marketscan Claims Database (Truven Health Analytics, Ann Arbor, Michigan) which covers most privately insured patients under the age of 65 in the USA from 2005 to 2014. Foot and ankle surgeries in the United States (US) are currently performed by orthopaedic surgeons or podiatrists with specialty surgical training. ![]()
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