Comparison of complications and reoperations in AO/OTA 43.C3 pilon fractures treated with conventional ORIF versus minimally invasive hexapod ring fixation

Controversy exists regarding the optimal management of AO/OTA 43. C3 pilon fractures. Open reduction and internal fixation (ORIF) is the gold standard treatment, but serious soft tissue and infectious complications have been previously reported. Minimally invasive strategies using hexapod ring fixat...

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Bibliographic Details
Published in:Injury 2023-11, Vol.54 Suppl 6, p.110884-110884, Article 110884
Main Authors: Bastías, Gonzalo F, Sepúlveda, Sebastián, Bruna, Sergio, Contreras, Martin, Hube, Maximiliano, Cuchacovich, Natalio, Bergeret, Juan Pedro, Fuentes, Patricio
Format: Article
Language:English
Subjects:
Ankle Fractures - diagnostic imaging
Ankle Fractures - surgery
Ankle Injuries - surgery
Bone Plates
Follow-Up Studies
Fracture Fixation, Internal - methods
Humans
Osteoarthritis - surgery
Reoperation
Retrospective Studies
Tibial Fractures - surgery
Treatment Outcome
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Summary:Controversy exists regarding the optimal management of AO/OTA 43. C3 pilon fractures. Open reduction and internal fixation (ORIF) is the gold standard treatment, but serious soft tissue and infectious complications have been previously reported. Minimally invasive strategies using hexapod ring fixation (HRF) with supplemental limited internal fixation have been used to reduce the incidence of complications. Previous studies have included heterogeneous types of pilon fractures, with non-comminuted injuries being more likely to be treated with ORIF and complex fractures receiving HRF treatment. To our knowledge, no studies have compared the complications and reoperation rates between ORIF and HRF exclusively for C3 fractures. Retrospective study comparing 53 patients treated for AO/OTA 43.C3 pilon fracture with ORIF or HRF in a trauma level I center with at least a two-year follow-up. Patients treated between January 2015 and January 2019 received ORIF and those treated between January 2019 and January 2021 received HRF. Complications were divided into two groups: minor (superficial infection and malalignment) and major (non-union, deep infection, and amputation). Reoperations, prevalence of ankle osteoarthritis, and requirement for ankle arthrodesis/total ankle replacement were registered. We included 30 and 23 patients in the ORIF and HRF groups, respectively. The overall complication rate was similar in both groups, with 50% and 56,5% of the patients having complications in the ORIF and HRF groups, respectively (p:0,63). Minor complications were significantly more prevalent in the HRF group (p
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2023.110884