title: Hybrid External Fixation for Arbeitsgemeinschaft für Osteosynthesefragen (AO) 43-C Tibial Plafond Fractures.
abstract: Arbeitsgemeinschaft für Osteosynthesefragen (AO) type 43-C tibial plafond/pilon fractures represent a challenge for the treating orthopedic surgeon. We assessed the outcomes of using hybrid external fixation for this fracture type. The present prospective cohort study was started in August 2009 and ended by July 2012. Thirty consecutive patients (mean age 37.4 ± 10.7 years) with a type C tibial plafond fracture who had presented to our tertiary care orthopedic hospital were included. Motor vehicle accidents and fall from height were the cause of the fracture in 14 (46.7%) and 13 (43.3%) patients, respectively. A type C3 fracture was present in 25 patients (83.3%), and type C1 and C2 fractures were present in 2 (6.7%) and 3 (10.0%) patients, respectively. Nine fractures (30.0%) were open. Hybrid external fixation was used for all fractures. All fractures were united; clinical healing was achieved by a mean of 18.1 ± 2.2 weeks postoperatively and radiologic healing at a mean of 18.9 ± 1.9 weeks. The fixator was removed at a mean of 20.4 ± 2.0 weeks postoperatively. At a mean follow-up point of 13.4 ± 2.6 months, the mean modified Mazur ankle score was 84.6 ± 10.4. It was not associated with wound classification (p = .256). The most commonly seen complication was ankle osteoarthritis (17 patients; 56.7%); however, it was mild in >50.0% of the affected patients. In conclusion, using hybrid external fixation for type C tibial plafond fractures resulted in good outcomes. However, this should be investigated further in studies with a higher level of evidence.
authors.affiliation: Orthopaedic Trauma Surgeon, Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait.
authors.forename: Emad
authors.initials: E
authors.lastname: Abd-Almageed
authors.affiliation: Orthopaedic Resident, Division of Orthopaedic Trauma, Department of Orthopaedic Hospital, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait. Electronic address: yousefmarwan@hotmail.com.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Marwan
authors.affiliation: Assistant Professor of Orthopaedic Surgery, Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, and Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
authors.forename: Ali
authors.initials: A
authors.lastname: Esmaeel
authors.affiliation: Orthopaedic Trauma Surgeon, Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait.
authors.forename: Amarnath
authors.initials: A
authors.lastname: Mallur
authors.affiliation: Assistant Professor of Orthopaedic Surgery, Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, and Department of Orthopaedic Surgery, Mansoura University, Mansoura, Egypt.
authors.forename: Barakat
authors.initials: B
authors.lastname: El-Alfy
mesh_terms: D000328:Adult; D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: ankle; external fixation; fracture; tibial pilon; tibial plafond; trauma