Surgical rehabilitation of patients with the consequences of pilon fractures

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Abstract

BACKGROUND: Pilon fracture is an intra-articular injury of tibia distal metaepiphysis; it’s often comminuted. Comprehensive reconstruction of the tibia articular surface and recovery of the axil in the affected extremity is of prime importance for the rehabilitation of patients with such pathology, so priority is given to reconstructive surgical techniques. Pilon injury often causes deforming arthrosis of the ankle joint that reduces its functions. It is ankle arthrodesis that is considered to be the preferred method of surgical rehabilitation in this clinical setting.

AIM: The presentation of successful outcomes in patients with consequences of intra-articular fractures of distal tibial metaepiphysis.

MATERIALS AND METHODS: Clinical and radiological methods were used to study the initial data and outcomes of 16 patients suffering from pilon fractures. The recovery of the supporting function of the foot and the level of pain syndrome after the treatment were evaluated with the Foot Functional Index questionnaire. Taking into account the obtained clinical and radiological data, all patients underwent bone-plastic arthrodesis of the ankle joint with correction of limb deformity. An intramedullary retrograde tibial lockable rod was used to fix the ankle joint.

RESULTS: It was established that the performance of bone-plastic arthrodesis of the ankle joint provides a complete restoration of the supporting function of the injured lower limb with the relief of pain in the period of 3–4 months after surgery.

CONCLUSION: The use of intramedullary retrograde rod with blocking for the fixation of the ankle joint does not require the use of additional immobilization, provides the possibility of early loading on the operated limb.

About the authors

Konstantin A. Grazhdanov

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; V.I. Razumovsky Saratov State Medical University

Author for correspondence.
Email: sarniito504@gmail.com
ORCID iD: 0000-0002-3523-4494
SPIN-code: 3651-9306

MD, PhD, Cand. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Saratov; Saratov

Pavel P. Zuev

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; V.I. Razumovsky Saratov State Medical University

Email: pasha.zuiev@mail.ru
ORCID iD: 0000-0002-0324-6503
SPIN-code: 1521-7718

MD, PhD, Cand. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Saratov; Saratov

Oleg A. Kauts

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; V.I. Razumovsky Saratov State Medical University

Email: oandreevich2009@yandex.ru
ORCID iD: 0000-0003-1822-1939
SPIN-code: 1305-6629

MD, PhD, Cand. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Saratov; Saratov

Nickolay I. Romanov

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; V.I. Razumovsky Saratov State Medical University

Email: rashid-uraz@rambler.ru

resident

Russian Federation, Saratov; Saratov

Yurij A. Barabash

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; V.I. Razumovsky Saratov State Medical University

Email: yubarabash@yandex.ru
ORCID iD: 0000-0002-8602-2715
SPIN-code: 2479-2371

MD, PhD, Dr. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Saratov; Saratov

Sergey I. Kireev

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; V.I. Razumovsky Saratov State Medical University

Email: kireevsi@rambler.ru
ORCID iD: 0000-0002-3318-5633
SPIN-code: 5885-9996

MD, PhD, Dr. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Saratov; Saratov

Igor A. Norkin

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; V.I. Razumovsky Saratov State Medical University

Email: sarniito@yandex.ru
ORCID iD: 0000-0002-6770-3398
SPIN-code: 9253-7993

MD, PhD, Dr. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Saratov; Saratov

References

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  8. Fomichev VA, Sorokin EP, Chugaev DV, et al. Ankle fusion is the optimal surgery for treatment of ankle arthritis (review). Department of Traumatology and Orthopedics. 2019;(4):18–26. (In Russ). doi: 10.17238/issn2226-2016.2019.4.18-26
  9. Morasiewicz P, Dejnek M, Kulej M, et al. Sport and physical activity after ankle arthrodesis with Ilizarov fixation and internal fixation. Adv Clin Exp. 2018;28(5):609–614. doi: 10.17219/acem/80258
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Supplementary files

Supplementary Files
Action
1. JATS XML
2. Figure. X-ray image of 40 y. o. patient T’s ankle joint (a) at presentation, (b) after the surgery, (c) in 14 months after the surgery, intramedullary fixator removed

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