Entrapped posteromedial structures in pilon fractures

Journal of Orthopaedic Trauma
Jonathan G EastmanRobert P Dunbar

Abstract

To analyze a patient cohort who sustained a tibial pilon fracture and report the incidence of interposed posteromedial soft tissue structures. Retrospective cohort review. Regional Level 1 Trauma Center. About 394 patients with 420 pilon fractures treated between January 2005 and November 2011. Each patient's preoperative radiographs and computed tomography (CT) images were reviewed. The axial and reconstructed images were used in bone and soft tissue windows to identify any posteromedial soft tissue structures incarcerated within the fracture. Medical charts reviewed for the presence of preoperative neurologic deficit, separate posteromedial incision, and whether attending radiology CT interpretation noted the interposed structure. 40 patients with 40 fractures (9.5%) had an entrapped posteromedial structure. The tibialis posterior tendon was interposed in 38/40 fractures (95%) and the posterior tibial neurovascular bundle in 4/40 fractures (10%). Preoperative neurologic deficit occurred in 5/40 patients (12%). A posteromedial incision was used in 11/40 fractures (27%). The attending radiology CT interpretation noted the interposed structure in 8/40 fractures (20%). In addition to the osseous injuries, CT imaging can demonstra...Continue Reading

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Citations

Aug 22, 2015·Der Unfallchirurg·K Klaue, P Cronier
Jul 30, 2016·Emergency Radiology·Yogesh S GuptaStephen Ling
Aug 9, 2016·BMC Musculoskeletal Disorders·Yukai WangCong Feng Luo
Jul 10, 2019·Emergency Radiology·Adam D SingerThomas J Moore
Oct 22, 2018·Current Reviews in Musculoskeletal Medicine·Jessica BearDavid Helfet
May 4, 2021·OTA International : the Open Access Journal of Orthopaedic Trauma·Sadaki MitsuzawaShuichi Matsuda
May 12, 2021·JBJS Case Connector·John C WuellnerJonathan G Eastman

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