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Журнал «Травма» Том 25, №3, 2024

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Хірургічна тактика при переломах дистального відділу великогомілкової кістки. Огляд літератури

Авторы: Бур’янов О.А., Цапенко Г.С., Омельченко Т.М.
Національний медичний університет імені О.О. Богомольця, м. Київ, Україна

Рубрики: Травматология и ортопедия

Разделы: Справочник специалиста

Версия для печати


Резюме

Актуальність. Переломи дистального епіметафіза великогомілкової кістки (перелом pilon) становлять 5–7 % від усіх переломів великогомілкової кістки та 10–15 % від усіх переломів кісток нижньої кінцівки. Частка незадовільних результатів лікування при переломах pilon залишається високою і досягає 38–40 %. Важливим фактором, що обумовлює такий високий відсоток незадовільних результатів лікування, є відсутність лікувальних алгоритмів, прийнятих протоколів лікування та системи прогнозування наслідків лікування. Мета: провести аналіз особливостей сучасної хірургічної тактики в разі переломів дистального відділу великогомілкової кістки, визначити дискусійні і невирішені питання, окреслити можливі причини значної кількості незадовільних результатів лікування цієї категорії пацієнтів, а також шляхи поліпшення результатів лікування. Матеріали та методи. Проведено огляд 878 публікацій в базі PubMed за останні 15 років. Відібрано та проаналізовано 210 публікацій. Застосовано методи аналітичної та описової статистики. Результати. Серед дискусійних питань, що найчастіше обговорюються в літературі та відносно яких відсутній консенсус або загальноприйнятий підхід, що має доказовість та обґрунтовану тактику, потрібно виділити наступні: вибір часу хірургічного втручання; вибір методу та засобу фіксації; раціональна тактика конверсії металоостеосинтезу; необхідність та значення відновлення малогомілкової кістки під час лікування переломів pilon; значення кісткової пластики та пріоритетність відновлення анатомії великогомілкової за принципом колон; місце первинного артродезу в хірургічній тактиці лікування переломів pilon. Висновки. Вказані питання потребують подальшого дослідження з розробкою нових обґрунтованих алгоритмізованих протоколів лікування, що базуватимуться на достатній доказовій базі та системі прогнозування результатів.

Background. Fractures of the distal tibial epimetaphysis (pilon fracture) account for 5–7 % of all tibial fractures and 10–15 % of all lower extremity bone fractures. The percentage of treatment failure in pilon fractures remains high and reaches 38–40 %. An important factor causing this is the lack of algorithms, accepted treatment protocols, and a system for predicting the effects of therapy. Purpose of the study: to analyze the features of modern surgical tactics in case of distal tibia fractures, to identify controversial and unresolved issues, to outline the possible reasons for a significant number of poor treatment outcomes, as well as to outline ways to improve them. Materials and methods. A review of 878 publications in the PubMed database over the past 15 years was conducted. 210 publications were selected and analyzed. The methods of analytical and descriptive statistics are applied. Results. Among the most debatable issues in the literature regarding which there is no consensus or a generally accepted approach that has evidence and justified tactics, the following should be highlighted: the choice of the time of surgical intervention; selection of method and means of fixation; rational tactics for osteosynthesis conversion; necessity and significance of fibula restoration during the treatment of pilon fractures; the importance of osteoplasty and the priority of restoring tibial anatomy according to the “column” principle; the place of primary arthrodesis in the surgical treatment for pilon fractures. Conclusions. These issues require further research with the development of new substantiated algorithmized treatment protocols based on a sufficient evidence base and a system for predicting the outcomes.


Ключевые слова

дистальний епіметафіз; великогомілкова кістка; перелом pilon; огляд літератури

distal epimetaphysis; tibia; pilon fracture; literature review


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Список литературы

1. Mauffrey C, Vasario G, Battiston B, Lewis C, Beazley J, Seligson D. Tibial pilon fractures: a review of incidence, diagnosis, treatment, and complications. Acta Orthop Belg. 2011 Aug;77(4):432-440.
2. Mandi DM, Belin RP, Banks J, Barrett B. Pilon fractures. Clin Podiatr Med Surg. 2012 Apr;29(2):243-78, viii. doi: 10.1016/j.cpm.2012.01.001.
3. Bourne RB. Pylon fractures of the distal tibia. Clin Orthop Relat Res. 1989 Mar;(240):42-46.
4. Kelikian H, Kelikian AS. Disorders of the ankle. Philadelphia, PA: WB Saunders Company; 1985. 893 p.
5. Mandracchia VJ, Evans RD, Nelson SC, Smith KM. Pilon fractures of the distal tibia. Clin Podiatr Med Surg. 1999 Oct;16(4):743-767.
6. McFerran MA, Smith SW, Boulas HJ, Schwartz HS. Complications encountered in the treatment of pilon fractures. J Orthop Trauma. 1992;6(2):195-200. doi: 10.1097/00005131-199206000-00011.
7. Tang X, Liu L, Tu CQ, Li J, Li Q, Pei FX. Comparison of Early and Delayed Open Reduction and Internal Fixation for Treating Closed Tibial Pilon Fractures. Foot Ankle Int. 2014 Jul;35(7):657-664. doi: 10.1177/1071100714534214.
8. Zheng Y, Zhang JD, Shen JM, Chen JJ, Toy L, Huang JF. A Modified 2-Stage Treatment for AO/OTA 43-C1 Pilon Fractures Accompanied by Distal Fibular and Posterior Lip of the Distal Tibia Fracture. J Foot Ankle Surg. 2020 Sep-Oct;59(5):972-978. doi: 10.1053/j.jfas.2020.03.020.
9. Carbonell-Escobar R, Rubio-Suarez JC, Ibarzabal-Gil A, Rodriguez-Merchan EC. Analysis of the variables affecting outcome in fractures of the tibial pilon treated by open reduction and internal fixation. J Clin Orthop Trauma. 2017 Oct-Dec;8(4):332-338. doi: 10.1016/j.jcot.2017.05.014.
10. Meng YC, Zhou XH. External fixation versus open reduction and internal fixation for tibial pilon fractures: A meta-ana-lysis based on observational studies. Chin J Traumatol. 2016 Oct 1;19(5):278-282. doi: 10.1016/j.cjtee.2016.06.002.
11. Marsh JL, Slongo TF, Agel J, et al. Fracture and dislocation classification compendium — 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007 Nov-Dec;21(Suppl 10):S1-133. doi: 10.1097/00005131-200711101-00001.
12. Rüedi T, Allgöwer M. Fractures of the lower end of the tibia into the ankle joint. Injury. 1969 Oct;1(2):92-99. doi: 10.1016/S0020-1383(69)80066-5.
13. Borrelli J Jr, Ellis E. Pilon fractures: assessment and treatment. Orthop Clin North Am. 2002 Jan;33(1):231-245, x. doi: 10.1016/s0030-5898(03)00082-8.
14. Topliss CJ, Jackson M, Atkins RM. Anatomy of pilon fractures of the distal tibia. J Bone Joint Surg Br. 2005 May;87(5):692-697. doi: 10.1302/0301-620X.87B5.15982.
15. Leonetti D, Tigani D. Pilon fractures: A new classification system based on CT-scan. Injury. 2017 Oct;48(10):2311-2317. doi: 10.1016/j.injury.2017.07.026.
16. Qiu XS, Li XG, Qi XY, Wang Z, Chen YX. What Is the Most Reliable Classification System to Assess Tibial Pilon Fractures? J Foot Ankle Surg. 2020 Jan-Feb;59(1):48-52. doi: 10.1053/j.jfas.2019.07.002.
17. Palma J, Villa A, Mery P, et al. A New Classification System for Pilon Fractures Based on CT Scan: An Independent Interobserver and Intraobserver Agreement Evaluation. J Am Acad Orthop Surg. 2020 Mar 1;28(5):208-213. doi: 10.5435/JAAOS-D-19-00390.
18. Bear J, Rollick N, Helfet D. Evolution in Management of Tibial Pilon Fractures. Curr Rev Musculoskelet Med. 2018 Dec;11(4):537-545. doi: 10.1007/s12178-018-9519-7.
19. Sirkin MS. Plating of tibial pilon fractures. Am J Orthop (Belle Mead NJ). 2007 Dec;36(12 Suppl 2):13-17.
20. Crist BD, Khazzam M, Murtha YM, Della Rocca GJ. Pilon fractures: advances in surgical management. J Am Acad Orthop Surg. 2011 Oct;19(10):612-22. doi: 10.5435/00124635-201110000-00005.
21. Ibrahim DA, Swenson A, Sassoon A, Fernando ND. Classifications In Brief: The Tscherne Classification of Soft Tissue Injury. Clin Orthop Relat Res. 2017 Feb;475(2):560-564. doi: 10.1007/s11999-016-4980-3.
22. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am. 1976 Jun;58(4):453-458.
23. Rommens PM, Claes P, Broos PL. Therapeutic strategy in pilon fractures type C2 and C3: soft tissue damage changes treatment protocol. Acta Chir Belg. 1996 Apr;96(2):85-92.
24. Dujardin F, Abdulmutalib H, Tobenas AC. Total fractures of the tibial pilon. Orthop Traumatol Surg Res. 2014 Feb;100(Suppl 1):S65-74. doi: 10.1016/j.otsr.2013.06.016.
25. Teeny SM, Wiss DA. Open reduction and internal fixation of tibial plafond fractures. Variables contributing to poor results and complications. Clin Orthop Relat Res. 1993 Jul;(292):108-117.
26. Kim JH, Patel S. Is it worth discriminating against patients who smoke? A systematic literature review on the effects of tobacco use in foot and ankle surgery. J Foot Ankle Surg. 2017 May-Jun;56(3):594-599. doi: 10.1053/j.jfas.2017.02.006.
27. Sirkin M, Sanders R, DiPasquale T, Herscovici D Jr. A staged protocol for soft tissue management in the treatment of complex pilon fractures. J Orthop Trauma. 2004 Sep;18(Suppl 8):S32-38. doi: 10.1097/00005131-200409001-00005.
28. Chen H, Cui X, Ma B, Rui Y, Li H. Staged procedure protocol based on the four-column concept in the treatment of AO/OTA type 43-C3.3 pilon fractures. J Int Med Res. 2019 May;47(5):2045-2055. doi: 10.1177/0300060519836512.
29. Boraiah S, Kemp TJ, Erwteman A, Lucas PA, Asprinio DE. Outcome following open reduction and internal fixation of open pilon fractures. J Bone Joint Surg Am. 2010 Feb;92(2):346-352. doi: 10.2106/JBJS.H.01678.
30. Tong D, Ji F, Zhang H, et al. Two-stage procedure protocol for minimally invasive plate osteosynthesis technique in the treatment of the complex pilon fracture. Int Orthop. 2012 Apr;36(4):833-837. doi: 10.1007/s00264-011-1434-0. 
31. White TO, Guy P, Cooke CJ, et al. The results of early primary open reduction and internal fixation for treatment of OTA 43.C-type tibial pilon fractures: a cohort study. J Orthop Trauma. 2010 Dec;24(12):757-763. doi: 10.1097/BOT.0b013e3181d04bc0. 
32. Malik-Tabassum K, Pillai K, Hussain Y, et al. Post-operative outcomes of open reduction and internal fixation versus circular external fixation in treatment of tibial plafond fractures: A systematic review and meta-analysis. Injury. 2020 Jul;51(7):1448-1456. doi: 10.1016/j.injury.2020.04.056. 
33. Korkmaz A, Ciftdemir M, Ozcan M, Copuroğlu C, Sarıdoğan K. The analysis of the variables, affecting outcome in surgically treated tibia pilon fractured patients. Injury. 2013 Oct;44(10):1270-1274. doi: 10.1016/j.injury.2013.06.016. 
34. Duckworth AD, Jefferies JG, Clement ND, White TO. Type C tibial pilon fractures: short- and long-term outcome following operative intervention. Bone Joint J. 2016 Aug;98-B(8):1106-1111. doi: 10.1302/0301-620X.98B8.36400. 
35. Koulouvaris P, Stafylas K, Mitsionis G, Vekris M, Mavrodontidis A, Xenakis T. Long-term results of various therapy concepts in severe pilon fractures. Arch Orthop Trauma Surg. 2007 Jul;127(5):313-320. doi: 10.1007/s00402-007-0306-y.
36. Marsh JL, Bonar S, Nepola JV, Decoster TA, Hurwitz SR. Use of an articulated external fixator for fractures of the tibial plafond. J Bone Joint Surg Am. 1995 Oct;77(10):1498-1509. doi: 10.2106/00004623-199510000-00004.
37. Tornetta P 3rd, Weiner L, Bergman M, et al. Pilon fractures: treatment with combined internal and external fixation. J Orthop Trauma. 1993;7(6):489-496. doi: 10.1097/00005131-199312000-00001.
38. Shah CM, Babb PE, McAndrew CM, et al. Definitive plates overlapping provisional external fixator pin sites: is the infection risk increased? J Orthop Trauma. 2014 Sep;28(9):518-522. doi: 10.1097/BOT.0000000000000077.
39. Zeng XT, Pang GG, Ma BT, et al. Surgical treatment of open pilon fractures. Orthop Surg. 2011 Feb;3(1):45-51. doi: 10.1111/j.1757-7861.2010.00113.x.
40. Stall A, Paryavi E, Gupta R, Zadnik M, Hui E, O’Toole RV. Perioperative supplemental oxygen to reduce surgical site infection after open fixation of high-risk fractures: a randomized controlled pilot trial. J Trauma Acute Care Surg. 2013 Oct;75(4):657-663. doi: 10.1097/TA.0b013e3182a1fe83.
41. O’Toole RV, Joshi M, Carlini AR, et al.; METRC. Supplemental Perioperative Oxygen to Reduce Surgical Site Infection After High-Energy Fracture Surgery (OXYGEN Study). J Orthop Trauma. 2017 Apr;31(Suppl 1):S25-S31. doi: 10.1097/BOT.0000000000000803.
42. D’Alleyrand JC, Manson TT, Dancy L, et al. Is time to flap coverage of open tibial fractures an independent predictor of flap-related complications? J Orthop Trauma. 2014 May;28(5):288-293. doi: 10.1097/BOT.0000000000000001.
43. He X, Hu Y, Ye P, Huang L, Zhang F, Ruan Y. The ope-rative treatment of complex pilon fractures: A strategy of soft tissue control. Indian J Orthop. 2013 Sep;47(5):487-492. doi: 10.4103/0019-5413.118205.
44. Wang Z, Qu W, Liu T, et al. A Two-Stage Protocol with Vacuum Sealing Drainage for the Treatment of Type C Pilon Fractures. J Foot Ankle Surg. 2016 Sep-Oct;55(5):1117-1120. doi: 10.1053/j.jfas.2016.01.047.
45. Swiontkowski MF, Sands AK, Agel J, Diab M, Schwappach JR, Kreder HJ. Interobserver variation in the AO/OTA fracture classification system for pilon fractures: is there a problem? J Orthop Trauma. 1997 Oct;11(7):467-470. doi: 10.1097/00005131-199710000-00002.
46. Lee YS, Chen SW, Chen SH, Chen WC, Lau MJ, Hsu TL. Stabilisation of the fractured fibula plays an important role in the treatment of pilon fractures: a retrospective comparison of fibular fixation methods. Int Orthop. 2009 Jun;33(3):695-699. doi: 10.1007/s00264-008-0654-4.
47. Evans JM, Gardner MJ, Brennan ML, Phillips CJ, Henley MB, Dunbar RP. Intramedullary fixation of fibular fractures associated with pilon fractures. J Orthop Trauma. 2010 Aug;24(8):491-494. doi: 10.1097/BOT.0b013e3181eb5c4f.
48. Stewart CM, Kiner D, Nowotarski P. Intramedullary nail fixation of fibular fractures associated with tibial shaft and pilon fractures. J Orthop Trauma. 2013 May;27(5):e114-117. doi: 10.1097/BOT.0b013e3182694a2d.
49. Ramlee MH, Sulong MA, Garcia-Nieto E, Penaranda DA, Felip AR, Kadir MRA. Biomechanical features of six design of the delta external fixator for treating Pilon fracture: a finite element study. Med Biol Eng Comput. 2018 Oct;56(10):1925-1938. doi: 10.1007/s11517-018-1830-3.
50. Papadokostakis G, Kontakis G, Giannoudis P, Hadjipavlou A. External fixation devices in the treatment of fractures of the tibial plafond: a systematic review of the literature. J Bone Joint Surg Br. 2008 Jan;90(1):1-6. doi: 10.1302/0301-620X.90B1.19858.
51. Torino D, Mehta S. Fibular Fixation in Distal Tibia Fractures: Reduction Aid or Nonunion Generator? J Orthop Trauma. 2016 Nov;30(Suppl 4):S22-S25. doi: 10.1097/BOT.0000000000000695.
52. Rouhani A, Elmi A, Akbari Aghdam H, Panahi F, Dokht Ghafari Y. The role of fibular fixation in the treatment of tibia diaphysis distal third fractures. Orthop Traumatol Surg Res. 2012 Dec;98(8):868-872. doi: 10.1016/j.otsr.2012.09.009.
53. Howard JL, Agel J, Barei DP, Benirschke SK, Nork SE. A prospective study evaluating incision placement and wound healing for tibial plafond fractures. J Orthop Trauma. 2008 May-Jun;22(5):299-305; discussion 305-6. doi: 10.1097/BOT.0b013e318172c811.
54. Kim GB, Shon OJ, Park CH. Treatment of AO/OTA Type C Pilon Fractures Through the Anterolateral Approach Combined With the Medial MIPO Technique. Foot Ankle Int. 2018 Apr;39(4):426-432. doi: 10.1177/1071100717746628.
55. Kurylo JC, Datta N, Iskander KN, Tornetta P 3rd. Does the Fibula Need to be Fixed in Complex Pilon Fractures? J Orthop Trauma. 2015 Sep;29(9):424-427. doi: 10.1097/BOT.0000000000000304.
56. Tomás-Hernández J. High-energy pilon fractures management: State of the art. EFORT Open Rev. 2017 Mar 13;1(10):354-361. doi: 10.1302/2058-5241.1.000016.
57. Bone LB. Fractures of the tibial plafond. The pilon fracture. Orthop Clin North Am. 1987 Jan;18(1):95-104.
58. Mast JW, Spiegel PG, Pappas JN. Fractures of the tibial pilon. Clin Orthop Relat Res. 1988 May;(230):68-82.
59. Rüedi T. Intraarticular fractures of distal tibia: results after 9 years. Arch Orthop Unfallchir. 1973;76(4):248-254. German. doi: 10.1007/BF00416372.
60. Ayeni JP. Pilon fractures of the tibia: a study based on 19 cases. Injury. 1988 Mar;19(2):109-114. doi: 10.1016/0020-1383(88)90085-x.
61. Borrelli J Jr, Torzilli PA, Grigiene R, Helfet DL. Effect of impact load on articular cartilage: development of an intra-articular fracture model. J Orthop Trauma. 1997 Jul;11(5):319-326. doi: 10.1097/00005131-199707000-00003.
62. Bourne RB, Rorabeck CH, Macnab J. Intra-articular fractures of the distal tibia: the pilon fracture. J Trauma. 1983 Jul;23(7):591-596. doi: 10.1097/00005373-198307000-00008.
63. Babis GC, Vayanos ED, Papaioannou N, Pantazopoulos T. Results of surgical treatment of tibial plafond fractures. Clin Orthop Relat Res. 1997 Aug;(341):99-105.
64. Teeny SM, Wiss DA. Open reduction and internal fixation of tibial plafond fractures. Variables contributing to poor results and complications. Clin Orthop Relat Res. 1993 Jul;(292):108-117.
65. Bastian L, Blauth M, Thermann H, Tscherne H. Various therapy concepts in severe fractures of the tibial pilon (type C injuries). A comparative study. Unfallchirurg. 1995 Nov;98(11):551-558. German.
66. Oestern HJ, Tscherne H. Pathophysiology and classification of soft tissue damage in fractures. Orthopade. 1983 Jan;12(1):2-8. German.
67. Rommens PM, Claes P, Broos PL. Therapeutic strategy in pilon fractures type C2 and C3: soft tissue damage changes treatment protocol. Acta Chir Belg. 1996 Apr;96(2):85-92.
68. Brumback RJ, McGarvey WC. Fractures of the tibial plafond. Evolving treatment concepts for the pilon fracture. Orthop Clin North Am. 1995 Apr;26(2):273-285.
69. Kellam JF, Waddell JP. Fractures of the distal tibial metaphysis with intra-articular extension — the distal tibial explosion fracture. J Trauma. 1979 Aug;19(8):593-601. doi: 10.1097/00005373-197908000-00007. 
70. Chen SH, Wu PH, Lee YS. Long-term results of pilon fractures. Arch Orthop Trauma Surg. 2007 Jan;127(1):55-60. doi: 10.1007/s00402-006-0225-3.
71. Lomax A, Singh A, N Jane M, Senthil KC. Complications and early results after operative fixation of 68 pilon fractures of the distal tibia. Scott Med J. 2015 May;60(2):79-84. doi: 10.1177/0036933015569159.
72. Cutillas-Ybarra MB, Lizaur-Utrilla A, Lopez-Prats FA. Prognostic factors of health-related quality of life in patients after tibial plafond fracture. A pilot study. Injury. 2015 Nov;46(11):2253-2257. doi: 10.1016/j.injury.2015.06.025.
73. Blauth M, Bastian L, Krettek C, Knop C, Evans S. Surgical options for the treatment of severe tibial pilon fractures: a study of three techniques. J Orthop Trauma. 2001 Mar-Apr;15(3):153-160. doi: 10.1097/00005131-200103000-00002.
74. Dickson KF, Montgomery S, Field J. High energy plafond fractures treated by a spanning external fixator initially and followed by a second stage open reduction internal fixation of the articular surface — preliminary report. Injury. 2001 Dec;32(Suppl 4):SD92-98. doi: 10.1016/s0020-1383(01)00163-2.
75. Patterson MJ, Cole JD. Two-staged delayed open reduction and internal fixation of severe pilon fractures. J Orthop Trauma. 1999 Feb;13(2):85-91. doi: 10.1097/00005131-199902000-00003.
76. Zhao L, Li Y, Chen A, Zhang Z, Xi J, Yang D. Treatment of type C pilon fractures by external fixator combined with limited open reduction and absorbable internal fixation. Foot Ankle Int. 2013 Apr;34(4):534-542. doi: 10.1177/1071100713480344.
77. Zhao Y, Wu J, Wei S, et al. Surgical approach strategies for open reduction internal fixation of closed complex tibial Pilon fractures based on axial CT scans. J Orthop Surg Res. 2020 Jul 27;15(1):283. doi: 10.1186/s13018-020-01770-y.
78. Bartoníček J, Rammelt S, Kostlivý K, Vaněček V, Klika D, Trešl I. Anatomy and classification of the posterior tibial fragment in ankle fractures. Arch Orthop Trauma Surg. 2015 Apr;135(4):505-516. doi: 10.1007/s00402-015-2171-4.
79. Keiler A, Riechelmann F, Thöni M, Brunner A, Ulmar B. Three-dimensional computed tomography reconstruction improves the reliability of tibial pilon fracture classification and preoperative surgical planning. Arch Orthop Trauma Surg. 2020 Feb;140(2):187-195. doi: 10.1007/s00402-019-03259-8.
80. Donohoe S, Alluri RK, Hill JR, Fleming M, Tan E, Marecek G. Impact of Computed Tomography on Operative Planning for Ankle Fractures Involving the Posterior Malleolus. Foot Ankle Int. 2017 Dec;38(12):1337-1342. doi: 10.1177/1071100717731568.
81. Ford SE, Ellington JK. Management of Distal Tibial Metaphyseal Bone Defects with an Intramedullary Nitinol Scaffold: A Novel Technique. Foot Ankle Spec. 2017 Aug;10(4):368-371. doi: 10.1177/1938640016679708.
82. Luo H, Chen L, Liu K, Peng S, Zhang J, Yi Y. Minimally invasive treatment of tibial pilon fractures through arthroscopy and external fixator-assisted reduction. Springerplus. 2016 Nov 5;5(1):1923. doi: 10.1186/s40064-016-3601-7.
83. Cole PA, Mehrle RK, Bhandari M, Zlowodzki M. The pilon map: fracture lines and comminution zones in OTA/AO type 43C3 pilon fractures. J Orthop Trauma. 2013 Jul;27(7):e152-156. doi: 10.1097/BOT.0b013e318288a7e9.
84. Assal M, Ray A, Stern R. Strategies for surgical approaches in open reduction internal fixation of pilon fractures. J Orthop Trauma. 2015 Feb;29(2):69-79. doi: 10.1097/BOT.0000000000000218.
85. Ali AM, El-Shafie M, Willett KM. Failure of fixation of tibial plateau fractures. J Orthop Trauma. 2002 May;16(5):323-329. doi: 10.1097/00005131-200205000-00006.
86. Wang D, Liu Y, Liu Y, et al. A dual functional bone-defect-filling material with sequential antibacterial and osteoinductive properties for infected bone defect repair. J Biomed Mater Res A. 2019 Oct;107(10):2360-2370. doi: 10.1002/jbm.a.36744.
87. Chen L, O’Shea K, Early JS. The use of medial and lateral surgical approaches for the treatment of tibial plafond fractures. J Orthop Trauma. 2007 Mar;21(3):207-211. doi: 10.1097/01.bot.0000246410.25423.3e.88. Chen DW, Li B, Aubeeluck A, Yang YF, Zhou JQ, Yu GR. Open reduction and internal fixation of posterior pilon fractures with buttress plate. Acta Ortop Bras. 2014;22(1):48-53. doi: 10.1590/S1413-78522014000100009. 
89. Aneja A, Luo TD, Liu B, et al. Anterolateral distal tibia locking plate osteosynthesis and their ability to capture OTAC3 pilon fragments. Injury. 2018 Feb;49(2):409-413. doi: 10.1016/j.injury.2017.12.015.
90. Oken OF, Yildirim AO, Asilturk M. Finite element ana-lysis of the stability of AO/OTA 43-C1 type distal tibial fractures treated with distal tibia medial anatomic plate versus anterolateral anatomic plate. Acta Orthop Traumatol Turc. 2017 Oct;51(5):404-408. doi: 10.1016/j.aott.2017.09.003.
91. Penny P, Swords M, Heisler J, Cien A, Sands A, Cole P. Ability of modern distal tibia plates to stabilize comminuted pilon fracture fragments: Is dual plate fixation ne-cessary? Injury. 2016 Aug;47(8):1761-1769. doi: 10.1016/j.injury.2016.05.026.
92. Amorosa LF, Brown GD, Greisberg J. A surgical approach to posterior pilon fractures. J Orthop Trauma. 2010 Mar;24(3):188-193. doi: 10.1097/BOT.0b013e3181b91927.
93. Kim GB, Shon OJ, Park CH. Treatment of AO/OTA Type C Pilon Fractures Through the Anterolateral Approach Combined With the Medial MIPO Technique. Foot Ankle Int. 2018 Apr;39(4):426-432. doi: 10.1177/1071100717746628.
94. Hardeski D, Gaski G, Joshi M, et al. Can applied external fixators be sterilized for surgery? A prospective cohort study of orthopaedic trauma patients. Injury. 2016 Dec;47(12):2679-2682. doi: 10.1016/j.injury.2016.07.009.
95. Davidovitch RI, Elkhechen RJ, Romo S, Walsh M, Egol KA. Open reduction with internal fixation versus limited internal fixation and external fixation for high grade pilon fractures (OTA type 43C). Foot Ankle Int. 2011 Oct;32(10):955-961. doi: 10.3113/FAI.2011.0955.
96. Arrondo GM, Joannas G. Complex Ankle Fractures: Practical Approach for Surgical Treatment. Foot Ankle Clin. 2020 Dec;25(4):587-595. doi: 10.1016/j.fcl.2020.08.002.
97. Guan J, Huang M, Wang Q, Chen Y, Wang L. Treatment of AO/OTA 43-C3 Pilon Fracture: Be Aware of Posterior Co–lumn Malreduction. Biomed Res Int. 2019 Apr 14;2019:4265782. doi: 10.1155/2019/4265782.
98. Ketz J, Sanders R. Staged posterior tibial plating for the treatment of Orthopaedic Trauma Association 43C2 and 43C3 tibial pilon fractures. J Orthop Trauma. 2012 Jun;26(6):341-347. doi: 10.1097/BOT.0b013e318225881a.
99. Vicenti G, Bizzoca D, Nappi VS, et al. The impact of lag screw in the healing time of distal tibia fractures treated with minimally invasive plate osteosynthesis: A randomized clinical trial. Injury. 2020 Aug;51(Suppl 3):S80-S85. doi: 10.1016/j.injury.2020.02.042.
100. Hasenboehler E, Rikli D, Babst R. Locking compression plate with minimally invasive plate osteosynthesis in diaphyseal and distal tibial fracture: a retrospective study of 32 patients. Injury. 2007 Mar;38(3):365-370. doi: 10.1016/j.injury.2006.10.024.
101. Prasad P, Nemade A, Anjum R, Joshi N. Extra-articular distal tibial fractures, is interlocking nailing an option? A prospective study of 147 cases. Chin J Traumatol. 2019 Apr;22(2):103-107. doi: 10.1016/j.cjtee.2018.12.005.
102. Biz C, Angelini A, Zamperetti M, et al. Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques. Biomed Res Int. 2018 Mar 1;2018:6054021. doi: 10.1155/2018/6054021.
103. Milenković S, Mitković M, Micić I, et al. Distal tibial pilon fractures (AO/OTA type B, and C) treated with the external skeletal and minimal internal fixation method. Vojnosanit Pregl. 2013 Sep;70(9):836-841. doi: 10.2298/vsp1309836m.
104. Leonard M, Magill P, Khayyat G. Minimally-invasive treatment of high velocity intra-articular fractures of the distal tibia. Int Orthop. 2009 Aug;33(4):1149-1153. doi: 10.1007/s00264-008-0629-5.
105. Nicholas PRM, Carter R, Chan P, Jamal B. A Systematic Review оf Primary Ankle Arthrodesis in the Treatment оf Pilon Fractures. Foot (Edinb). 2021 Jun;47:101780. doi: 10.1016/j.foot.2021.101780.
106. Morgan SJ, Thordarson DB, Shepherd LE. Salvage of tibial pilon fractures using fusion of the ankle with a 90 degrees cannulated blade-plate: a preliminary report. Foot Ankle Int. 1999 Jun;20(6):375-378. doi: 10.1177/107110079902000606.
107. Yajima H, Kobata Y, Tomita Y, Kawate K, Sugimoto K, Takakura Y. Ankle and pantalar arthrodeses using vascularized fibular grafts. Foot Ankle Int. 2004 Jan;25(1):3-7. doi: 10.1177/107110070402500102.
108. Beaman DN, Gellman R. Fracture reduction and primary ankle arthrodesis: a reliable approach for severely comminuted tibial pilon fracture. Clin Orthop Relat Res. 2014 Dec;472(12):3823-3834. doi: 10.1007/s11999-014-3683-x.
109. Persigant M, Colin F, Noailles T, Pietu G, Gouin F. Functional assessment of transplantar nailing for ankle fracture in the elderly: 48 weeks’ prospective follow-up of 14 patients. Orthop Traumatol Surg Res. 2018 Jun;104(4):507-510. doi: 10.1016/j.otsr.2018.03.008.
110. Zelle BA, Gruen GS, McMillen RL, Dahl JD. Primary Arthrodesis of the Tibiotalar Joint in Severely Comminuted High-Energy Pilon Fractures. J Bone Joint Surg Am. 2014 Jun 4;96(11):e91. doi: 10.2106/JBJS.M.00544.
111. Ho B, Ketz J. Primary Arthrodesis for Tibial Pilon Fractures. Foot Ankle Clin. 2017 Mar;22(1):147-161. doi: 10.1016/j.fcl.2016.09.010.
112. Ling JS, Smyth NA, Fraser EJ, et al. Investigating the relationship between ankle arthrodesis and adjacent-joint arthritis in the hindfoot: a systematic review. J Bone Joint Surg Am. 2015 Mar 18;97(6):513-520. doi: 10.2106/JBJS.N.00426.

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