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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 1, 1-6.
doi: 10.1302/0301-620X.90B1.19858  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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External fixation devices in the treatment of fractures of the tibial plafond

A SYSTEMATIC REVIEW OF THE LITERATURE

G. Papadokostakis, MD, Orthopaedic Surgeon1; G. Kontakis, MD, Assistant Professor of Orthopaedics1; P. Giannoudis, MD, Professor of Trauma and Orthopaedics2; and A. Hadjipavlou, MD, Professor Chairman of Orthopaedics1

1 University Hospital of Crete, P.O. Box 1352, 7110 Heraklion, Crete, Greece.
2 Department of Trauma and Orthopaedics, Glawedon Wing floor A, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.

Correspondence should be sent to Professor A. Hadjipavlou; e-mail: ahadjipa{at}med.uoc.gr

We have compared the outcomes of the use of external fixation devices for spanning or sparing the ankle joint in the treatment of fractures of the tibial plafond, focusing on the complications and the rates of healing. We have devised a scoring system for the quality of reporting of clinical outcomes, to determine the reliability of the results.

We conducted a search of publications in English between 1990 and 2006 using the Pubmed search engine. The key words used were pilon, pylon, plafond fractures, external fixation. A total of 15 articles, which included 465 fractures, were eligible for final evaluation.

There were no statistically significant differences between spanning and sparing fixation systems regarding the rates of infection, nonunion, and the time to union. Patients treated with spanning frames had significantly greater incidence of malunion compared with patients treated with sparing frames. In both groups, the outcome reporting score was very low; 60% of reports involving infection, nonunion or malunion scored 0 points.




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G. Kontakis, C. Koutras, T. Tosounidis, and P. Giannoudis
Early management of proximal humeral fractures with hemiarthroplasty: A SYSTEMATIC REVIEW
J Bone Joint Surg Br, November 1, 2008; 90-B(11): 1407 - 1413.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General