title: A Two-Stage Protocol With Vacuum Sealing Drainage for the Treatment of Type C Pilon Fractures.
abstract: Management of type C pilon fractures remains controversial and challenging. The aim of the present study was to provide a 2-stage protocol with vacuum sealing drainage for the treatment of type C pilon fractures. From March 2009 to March 2012, 16 patients (mean age 42.3 years) were admitted to our department with type C pilon fractures and treated with single-stage external fixation and second-stage internal fixation (anteromedial incision) combined with vacuum sealing drainage. The American Orthopaedic Foot and Ankle Society scale score averaged 86.5 for this group of patients. The range of motion was 30° ± 8.9°. An excellent or good American Orthopaedic Foot and Ankle Society scale score was obtained for all patients. None of the 16 patients developed skin necrosis, nonunion, or fixation failure during the follow-up period. Moreover, the visual analog scale pain scores were 0.7 ± 0.8, 0.9 ± 0.7, and 1.4 ± 1.0 during rest, active movement, and weightbearing, respectively. The postoperative radiographs showed excellent treatment effects. A 2-stage protocol, combined with vacuum sealing drainage, for the treatment of type C pilon fractures can eliminate deep infection and complex surgery and is a simple and effective treatment method. In addition, full exposure of the anteromedial incision, the avoidance of the anterior tibial muscle tendon sheath, and the avoidance of soft tissue injuries are generally recommended in this operation.
authors.affiliation: Orthopaedist, Department of Orthopaedic and Trauma, Yantaishan Hospital; and Orthopaedist, Department of Orthopaedic and Trauma, Yantai Sino-French Friendship Hospital, Yantai, People's Republic of China. Electronic address: ytzhenhai@163.com.
authors.forename: Zhenhai
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Surgeon, Department of Orthopaedic and Trauma, Yantaishan Hospital; and Surgeon, Department of Orthopaedic and Trauma, Yantai Sino-French Friendship Hospital, Yantai, People's Republic of China.
authors.forename: Wenqing
authors.initials: W
authors.lastname: Qu
authors.affiliation: Surgeon, Department of Orthopaedic and Trauma, Yantaishan Hospital; and Surgeon, Department of Orthopaedic and Trauma, Yantai Sino-French Friendship Hospital, Yantai, People's Republic of China.
authors.forename: Tong
authors.initials: T
authors.lastname: Liu
authors.affiliation: Surgeon, Department of Orthopaedic and Trauma, Yantaishan Hospital; and Surgeon, Department of Orthopaedic and Trauma, Yantai Sino-French Friendship Hospital, Yantai, People's Republic of China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Surgeon, Department of Orthopaedic and Trauma, Yantaishan Hospital; and Surgeon, Department of Orthopaedic and Trauma, Yantai Sino-French Friendship Hospital, Yantai, People's Republic of China.
authors.forename: Zhongyuan
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Surgeon, Department of Orthopaedic and Trauma, Yantaishan Hospital; and Surgeon, Department of Orthopaedic and Trauma, Yantai Sino-French Friendship Hospital, Yantai, People's Republic of China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.affiliation: Orthopaedist, Department of Orthopaedic and Trauma, Yantaishan Hospital; and Orthopaedist, Department of Orthopaedic and Trauma, Yantai Sino-French Friendship Hospital, Yantai, People's Republic of China.
authors.forename: Limin
authors.initials: L
authors.lastname: Cheng
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
keywords: anteromedial incision; pilon fracture; staged surgery; tibia; vacuum seal