Related Experiment Video

Updated: Sep 21, 2025

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
04:19

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

Published on: November 8, 2024

606

Perioperative Impact of Early Limited Surgical Intervention to Treat Pilon Fractures

Jeremy Hreha1, Michael D Metrione1, Mark C Reilly1

  • 1Department of Orthopaedic Surgery, Rutgers-New Jersey Medical School, Newark, NJ, USA.

Foot & Ankle International
|June 1, 2022
PubMed

Insights

Limited tibial reduction and fixation (LTRF) for pilon fractures significantly speeds up definitive fixation and reduces overall operative time. This approach maintains comparable infection and reduction quality outcomes to traditional staged protocols.

Area of Science:

  • Orthopedic surgery
  • Trauma surgery
  • Skeletal fixation techniques

Background:

  • Pilon fractures are classically treated with staged protocols to minimize soft tissue complications.
  • Traditional staged treatment involves external fixation followed by open reduction and internal fixation (ORIF).
  • Alternative approaches aim to reduce complications associated with acute definitive fixation.

Purpose of the Study:

  • To compare the outcomes of traditional staged pilon fracture treatment with a limited tibial reduction and fixation (LTRF) during the index procedure.
  • To evaluate the impact of LTRF on time to definitive fixation and overall operative duration.
  • To assess differences in infection rates, reduction quality, and nonunion rates between the two treatment groups.

Main Methods:

  • Retrospective cohort study of 113 patients with pilon fractures treated between September 2012 and November 2018.
  • Patients were divided into two groups: traditional staged protocol and LTRF during the index procedure.
  • Key outcome measured was the time to definitive fixation; secondary outcomes included operative times, infection rates, reduction quality, and nonunion rates.

Main Results:

  • The LTRF group showed a significantly shorter mean time to definitive ORIF (10.86 days) compared to the standard group (15.61 days).
  • While the index procedure was longer in the LTRF group, the definitive ORIF operative time was reduced, leading to a shorter overall operative duration.
  • No significant differences were observed in infection rates (3.1% LTRF vs. 2.5% standard), reduction quality, or nonunion rates between the groups.

Conclusions:

  • Limited tibial reduction and fixation (LTRF) during the index procedure for pilon fractures leads to quicker definitive ORIF.
  • LTRF reduces overall operative time without compromising infection rates, reduction quality, or union rates.
  • This modified approach offers a viable alternative to traditional staged protocols for pilon fracture management.
Abstract

Keywords:
limited tibial reduction and fixationpilonstaged treatmenttrauma

More Related Videos

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner04:41

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner

Published on: June 6, 2025

247
Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling15:11

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Published on: January 5, 2015

64.1K

Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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...
3.8K
Flail Chest-II01:26

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
243
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
29