Add like
Add dislike
Add to saved papers

Treatment protocol for open AO/OTA type C3 pilon fractures with segmental bone loss.

OBJECTIVES: To evaluate the results in patients with open AO/OTA type C3 pilon fractures with segmental bone loss who were treated with a standard treatment protocol.

DESIGN: Retrospective case series.

SETTING: Level I trauma center.

PATIENTS/PARTICIPANTS: Of 117 acute open type C pilon fractures treated during the study period, 10 patients with AO/OTA type C3 fractures and segmental metaphyseal bone loss were amenable to treatment with a standard protocol.

INTERVENTION: All patients were treated with immediate debridement and external fixation (stage 1). After a delay of 1-3 weeks, patients with a healthy-appearing soft tissue envelope and no sign of infection underwent open reduction, plate fixation, and antibiotic bead placement (stage 2). Several months later, planned bone grafting was performed (stage 3).

MAIN OUTCOME MEASUREMENTS: The complication rate, additional procedures, and time to bony union were determined.

RESULTS: The treatment protocol was able to be completed in all 10 patients. No cases of acute infection or wound necrosis after plate fixation and antibiotic bead placement occurred. Two cases of late infection occurred after delayed bone grafting, one of which was successfully treated and the other resulted in amputation. Nine of the 10 patients healed at an average of 24 weeks.

CONCLUSIONS: Limb salvage in the most severe open pilon fractures is difficult. In patients with benign soft tissues at several weeks after temporary external fixation, open reduction, antibiotic bead placement, and a delayed bone grafting procedure are associated with a low complication rate and predictable fracture healing.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app