Osteonecrosis of the distal tibia after pilon fractures
David J Cinats1, Trevor Stone1, Darius Viskontas1
1Royal Columbian Hospital, New Westminster, British Columbia, Canada; Department of Orthopaedics, University of British Columbia, Canada.
Background:
Pilon fractures are devastating injuries with high complication rates. Osteonecrosis has been previously described after Weber C fracture-dislocations but has not been reported following fixation of pilon fractures.
Methods:
All AO/OTA 43-C pilon fractures from 2007 to 2018 were reviewed. Injury factors and demographics were recorded. Computed tomography (CT) scans of the fracture pattern were analyzed to determine risk factors for ON.
Results:
71 pilon fractures in 69 patients were included. Mean follow-up was 21.6 months. 18 patients demonstrated ON at a mean 7.3 months' post-injury. Regression analysis demonstrated no differences between cohorts with respect to smoking status, open injury, or diabetic status. ON was associated with small anterolateral fragment less than 2.0cm2 (OR=19.47, p=0.012), higher comminution (OR=3.00, p=0.005), use of calcium phosphate bone substitute (OR=20.72, p=0.013).
Conclusions:
ON of the distal tibia was not associated with patient factors but was associated with fracture characteristics.
More Related Videos
07:41An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
Published on: November 13, 2016
04:41Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:16Bones of the Lower Limb: Femur and Patella
01:10Bones of the Lower Limb: Tibia and Fibula
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...