Document Detail


Clinical outcome and changes in gait pattern after pilon fractures.
MedLine Citation:
PMID:  23229797     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Axial burst fractures of the distal tibia are challenging to treat and often lead to restricted function of the lower limb. The purpose of this study was to investigate the clinical outcome and changes in gait pattern in such patients.
METHODS: Thirty-five patients in a level 1 trauma centre were followed up clinically and by gait analysis. The American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS) foot and ankle scale and Phillips scores were applied. Dynamic pedography (emed-M; Novel, Germany) with analyses of load, pressure and force-time integral were undertaken to investigate possible changes in gait pattern.
RESULTS: Mean follow-up was 50 (19-100) months. Mean AOFAS, VAS foot and ankle and Phillips scores were 65, 63 and 55 points, respectively. There were clear correlations between fracture severity in the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification and functional outcome in AOFAS (-0.63; p < 0.01), VAS foot and ankle scale (-0.56; p < 0.01) and Phillips (-0.64; p < 0.01) scores. There was a high correlation of 0.74 (p < 0.01) between the severity of the injury in the AO-classification and onset of post-traumatic arthrosis. Dynamic pedography revealed lesser load bearing for the total foot, medial foot, heel, first metatarsal and medial forefoot for the affected limb, and increased load bearing was seen in the lateral midfoot region.
CONCLUSIONS: Fractures of the tibial pilon lead to restricted function of the lower limb. Clinical outcome correlates with fracture severity in the AO classification, the onset of post-traumatic arthrosis and changes in gait patterns.
Authors:
Hendrik Jansen; Annabel Fenwick; Stefanie Doht; Soenke Frey; Rainer Meffert
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Publication Detail:
Type:  Journal Article     Date:  2012-12-11
Journal Detail:
Title:  International orthopaedics     Volume:  37     ISSN:  1432-5195     ISO Abbreviation:  Int Orthop     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-31     Completed Date:  2013-05-27     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  7705431     Medline TA:  Int Orthop     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  51-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Analysis of Variance
Ankle Joint / physiopathology*
Female
Follow-Up Studies
Gait / physiology*
Humans
Male
Middle Aged
Pain Measurement
Pressure
Questionnaires
Range of Motion, Articular / physiology
Tibial Fractures / physiopathology*,  radiography,  surgery*
Tomography, X-Ray Computed
Treatment Outcome
Weight-Bearing
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