![]() Failure to identify this fracture pattern has led to poor clinical outcomes and persistent talar subluxation. Fractures that involve the posteromedial plafond extending to the medial malleolus have been described previously in small case series. Level of Evidence: Level IV, retrospective case series.Ībstract = "Background: Posterior malleolus fractures occur in 7% to 44% of ankle fractures and are associated with worse clinical outcomes. In addition, a novel classification scheme is described to guide recognition and treatment of this fracture pattern. Our results following fixation of this fracture pattern are comparable with results in the literature. Conclusion: The posterior pilon fracture is a challenging fracture pattern to treat, and it has unique characteristics that require careful attention to operative technique. Four complications required operative intervention 2 patients reported continued pain secondary to development of CRPS. Five of 7 patients demonstrated ankle and hindfoot range of motion within 5 degrees of the uninvolved extremity. Anatomical reduction of the plafond was noted radiographically in 7 of 11 patients, with the remainder demonstrating less than 2 mm of articular incongruity. Results: Our mean postoperative AOFAS ankle/hindfoot score was 82. Patient records were reviewed to evaluate for secondary complications or operative procedures. ![]() Methods: Eleven patients were identified following fixation of a posterior pilon fracture over a 4-year span 7 returned at minimum 1-year follow-up to complete a physical examination, radiographs, and RAND-36 (health-related quality of life score developed at RAND as part of the Medical Outcomes Study) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot questionnaires. The purpose of this study was to report our outcomes following fixation of this posterior pilon fracture and to describe a novel classification system to help guide operative planning and fixation. Therefore, rehabilitation strategies should be developed to regain dorsiflexion motion as early as possible in the rehabilitation course.Background: Posterior malleolus fractures occur in 7% to 44% of ankle fractures and are associated with worse clinical outcomes. It is this unique structure that can have implications for rehabilitation in that loss of dorsiflexion is much more common than loss of plantarflexion motion. In the non–weight-bearing, plantarflexed position, ankle joint stability is mostly conferred from the ligamentous structures. In standing, the relatively dorsiflexed ankle joint behaves like a true mortise, with stability conferred principally by articular contact. The unique osseous anatomy of the talocrural joint, in which the talus is wider anteriorly than posteriorly, provides stability in dorsiflexion and relative mobility in plantarflexion. The dome itself is wider anteriorly than posteriorly as the ankle dorsiflexes, the fibula rotates externally through the tibiofibular syndesmosis to accommodate this widened anterior surface of the talar dome. The joint is considered saddle-shaped, with a larger circumference of the talar dome circumference laterally than medially. It consists of the tibial plafond, including the posterior malleolus articulating with the body of the talus, the medial malleolus, and the lateral malleolus. The ankle joint is a complex, three-bone joint.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |