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Efficacy of Temporal Fixation Using Threaded Trans-Calcaneal Pin in Patients with Ankle Fracture-Dislocation or Tibia Pilon Fractures

발목 골절 및 탈구 혹은 경골 천정 골절 환자들의 수술에 있어 경종골핀을 이용한 발목 외고정 장치를 적용했을 때의 임상적 효용성

  • Park, Dae-Hyun (Department of Orthopaedic Surgery, Inje University Busan Paik Hospital) ;
  • Gwak, Heui-Chul (Department of Orthopaedic Surgery, Inje University Busan Paik Hospital) ;
  • Kim, Jung-Han (Department of Orthopaedic Surgery, Inje University Busan Paik Hospital) ;
  • Lee, Chang-Rak (Department of Orthopaedic Surgery, Inje University Busan Paik Hospital) ;
  • Kwon, Yong-Uk (Department of Orthopaedic Surgery, Inje University Busan Paik Hospital) ;
  • Choo, Hye-Jung (Department of Radiology, Inje University Busan Paik Hospital) ;
  • Park, Chul-Soon (Department of Orthopaedic Surgery, Inje University Busan Paik Hospital)
  • 박대현 (인제대학교 부산백병원 정형외과) ;
  • 곽희철 (인제대학교 부산백병원 정형외과) ;
  • 김정한 (인제대학교 부산백병원 정형외과) ;
  • 이창락 (인제대학교 부산백병원 정형외과) ;
  • 권용욱 (인제대학교 부산백병원 정형외과) ;
  • 추혜정 (인제대학교 부산백병원 영상의학과) ;
  • 박철순 (인제대학교 부산백병원 정형외과)
  • Received : 2020.03.27
  • Accepted : 2020.05.22
  • Published : 2020.06.15

Abstract

Purpose: Ankle fractures with dislocations and pilon fractures at the distal tibia are usually associated with soft tissue damage caused by high-energy damage. Recently, a two-stage operation to perform internal fixation after the application of external fixation devices for stabilizing soft tissues has been accepted as the treatment of choice. This paper reports the clinical result of these injuries treated with threaded trans-calcaneal pin external fixation devices. Materials and Methods: Thirty-three patients diagnosed with ankle fractures with dislocations or tibial pilon fractures without open wounds. They underwent surgical treatment with threaded trans-calcaneal pin external fixation from January 2008 to February were enrolled in this study. This study evaluated the visual analogue scale (VAS), foot function index (FFI), and Olerud & Molander score as well as whether complications occurred. Results: The average VAS showed a meaningful decrease (p<0.001) from 7.4 before surgery to 2.6 after application of the external fixation device, and 1.4 at 12 months after surgery. The FFI also decreased significantly from 84.3 preoperatively to 20.3 at 12 months postoperatively (p<0.001). The Olerud & Molander score averaged 71.4 points, showing good clinical results. Complete bone union was observed in all patients. One patient each underwent debridement due to wound necrosis and infection in the pin insertion site. At the final follow-up, seven patients had posttraumatic ankle joint arthritis, according to a radiological examination. Conclusion: Manual reduction and external fixation using a threaded trans-calcaneal pin is a suitable surgical technique that is easy to perform and shows good clinical outcomes in stabilizing soft tissue damage in fractures and dislocations of ankle fracture or tibia pilon fractures in foot and ankle injury.

Keywords

References

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