Primary Total Ankle Replacement for Acute Comminuted Pilon Fractures in Older Adults: Proposed Indications and a Report of 29 Cases
Rattachement africain : kr, Nigéria. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Management of severe distal tibia pilon fractures (AO/OTA 43-C3) in older adults is exceptionally challenging. Open reduction and internal fixation is associated with a high incidence of posttraumatic arthritis, whereas primary arthrodesis results in significant functional limitations. We investigated primary total ankle replacement (TAR) as a definitive, single-stage, motion-preserving solution. MATERIALS AND METHODS: We retrospectively reviewed 29 older adult patients (age ≥60 years) treated with primary TAR since 2016 for comminuted pilon fractures. Inclusion required severe articular destruction (AO/OTA 43-C2/C3) but a reconstructable metaphyseal cortical shell. We evaluated surgical timing, adjunctive fixation, bone grafting, and clinical and radiographic outcomes. The primary outcome was the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at ≥6 months. RESULTS: At 6 months post-surgery, the mean AOFAS score was 85.2 ± 7.5. Metaphyseal fracture union was achieved in all cases at an average of 17.4 ± 2.1 weeks. Postoperative alignment was excellent, with a mean medial distal tibial angle (MDTA) of 89.2° ± 1.8°. No deep infections, insert dislocations, or component overhang were observed. Three patients (10.3%) developed progressive valgus deformity, with MDTA increasing by an average of 3.4° at 1 year. CONCLUSION: In this retrospective level IV series with short-term follow-up, primary TAR may be a feasible option for carefully selected older adult patients with comminuted pilon fractures and a preserved metaphyseal cortical shell, demonstrating encouraging early functional outcomes. Longer term follow-up is required to determine implant survivorship and revision risk.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Primary Total Ankle Replacement for Acute Comminuted Pilon Fractures in Older Adults: Proposed Indications and a Report of 29 Cases
- Date Crossref
- 01/03/2026
- Éditeur
- SLACK, Inc.
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Soonchunhyang University Hospital Seoul pays non établi dans la noticeÉtablissement de santé
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Sacred Heart Hospital Nigéria (code pays fourni par la source)Établissement de santé
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Hallym University Chuncheon Sacred Heart Hospital Department of Orthopaedic Surgery pays non établi dans la noticeÉtablissement de santé
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CHA University Bundang Medical Center pays non établi dans la noticeÉtablissement de santé
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Inje University Seoul Paik Hospital Department of Orthopaedic Surgery pays non établi dans la noticeÉtablissement de santé
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Soonchunhyang University Seoul Hospital Department of Orthopaedic Surgery pays non établi dans la noticeUniversité ou école supérieure
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CHA University School of Medicine Department of Orthopedic Surgery pays non établi dans la noticeUniversité ou école supérieure
Soonchunhyang University Hospital Seoul, Sacred Heart Hospital (Nigéria) et Department of Orthopaedic Surgery — Hallym University Chuncheon Sacred Heart Hospital, avec 4 autres affiliations. Pays d’affiliation : Nigéria.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.