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Acute Shortening and Arthrodesis Technique in Severe Irreparable Tibial Pilon Fracture

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Limb Lengthening and Reconstruction Surgery Case Atlas

Abstract

Severe soft tissue and bony injuries around the ankle present limb salvage challenges to the orthopedic trauma surgeon. Infection and soft tissue loss often lead to amputation. Reconstruction with external fixation helps prevent deep infection and allows for acute limb shortening as a means of managing the soft tissue loss without free flap coverage. Even significant limb shortening can be remedied with relative ease, utilizing the Ilizarov method of distraction osteogenesis. The following case highlights these principles with the additional use of an integrated fixation technique where a fusion lengthening performed with external fixation is converted during consolidation to internal fixation to decrease time in the frame.

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References and Suggested Reading

  • Cattaneo R, Catagni M, Johnson EE (1992) The treatment of infected nonunions and segmental defects of the tibia by the methods of Ilizarov. Clin Orthop Relat Res 280:143–152

    PubMed  Google Scholar 

  • Choudry U, Moran S, Karacor Z (2008) Soft-tissue coverage and outcome of Gustilo grade IIIB midshaft tibia fractures: a 15-year experience. Plast Reconstr Surg 122:479–485

    Article  CAS  PubMed  Google Scholar 

  • Dendrinos GK, Kontos S, Lyritsis E (1995) Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg Am 77:835–846

    CAS  PubMed  Google Scholar 

  • Fragomen AT, Borst E, Schachter L, Lyman S, Rozbruch SR (2012) Complex ankle arthrodesis using the Ilizarov method yields high rate of fusion. Clin Orthop Relat Res 470(10):2864–2873

    Article  PubMed Central  PubMed  Google Scholar 

  • Hollenbeck ST, Woo S, Ong S et al (2009) The combined use of the Ilizarov method and microsurgical techniques for limb salvage. Ann Plast Surg 62:486–491

    Article  CAS  PubMed  Google Scholar 

  • Hutson JJ Jr, Dayicioglu D, Oeltjen JC et al (2010) The treatment of Gustilo grade IIIB tibia fractures with application of antibiotic spacer, flap, and sequential distraction osteogenesis. Ann Plast Surg 64:541–552

    CAS  PubMed  Google Scholar 

  • McKee MD, Yoo DJ, Zdero R et al (2008) Combined single-stage osseous and soft tissue reconstruction of the tibia with the Ilizarov method and tissue transfer. J Orthop Trauma 22:183–189

    Article  PubMed  Google Scholar 

  • Nho SJ, Helfet DL, Rozbruch SR (2006) Temporary intentional leg shortening and deformation to facilitate wound closure using the Ilizarov/Taylor spatial frame. J Orthop Trauma 20:419–424

    Article  PubMed  Google Scholar 

  • Rozbruch SR, Weitzman AM, Watson JT et al (2006) Simultaneous treatment of tibial bone and soft-tissue defects with the Ilizarov method. J Orthop Trauma 20:197–205

    Google Scholar 

  • Sen C, Kocaoglu M, Eralp L et al (2004) Bifocal compression-distraction in the acute treatment of grade III open tibia fractures with bone and soft-tissue loss: a report of 24 cases. J Orthop Trauma 18:150–157

    Article  PubMed  Google Scholar 

  • Yazar S, Lin CH, Wei FC (2004) One-stage reconstruction of composite bone and soft-tissue defects in traumatic lower extremities. Plast Reconstr Surg 114:1457–1466

    Article  PubMed  Google Scholar 

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Correspondence to León Gonzalo Mora Herrera .

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© 2014 Springer International Publishing Switzerland

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Mora Herrera, L.G. (2014). Acute Shortening and Arthrodesis Technique in Severe Irreparable Tibial Pilon Fracture. In: Rozbruch, S., Hamdy, R. (eds) Limb Lengthening and Reconstruction Surgery Case Atlas. Springer, Cham. https://doi.org/10.1007/978-3-319-02767-8_126-1

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  • DOI: https://doi.org/10.1007/978-3-319-02767-8_126-1

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  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-02767-8

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