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. 2023 Jun;143(6):2855-2862.
doi: 10.1007/s00402-022-04456-8. Epub 2022 May 6.

Morbidities and prognostic factors after tibial pilon fracture: impact on patients

Choon Chiet Hong  1 , Si Heng Sharon Tan  2 , Soura Saha  2 , Christopher Jon Pearce  2
Affiliations

Morbidities and prognostic factors after tibial pilon fracture: impact on patients

Choon Chiet Hong et al. Arch Orthop Trauma Surg. 2023 Jun.

Abstract

Introduction: This study aims primarily to characterize the sequelae and morbidity associated with tibial pilon injuries from the patients' perspectives in terms of multiple surgical interventions, duration of hospital stay, downtime from work, loss of productivity and impact on patients' lives. The secondary aim is to review the associated risk factors for these morbidities.

Materials and methods: All patients with surgically treated tibial pilon fractures from 1st July 2007 to 30th June 2017 were included. The morbidities reviewed focused on delay to surgery, numbers of surgeries, limb amputation, length of stay (LOS), readmissions, duration of medical leave (ML), follow-up and number of outpatient visits.

Results: There were 102 patients included in the review and up to 70% of them had an average 7 days delay to definitive surgery. They also required an average hospital LOS of at least 2 weeks extending up to 3 more weeks if soft tissue reconstruction was necessitated. Up to a third of patients were readmitted with 15% of them needing further treatment. These patients required a notable period of downtime from work as shown in the long ML (mean 152.6 days [S.D. = 110.7]). Multiple conditional regression models showed AO/OTA classification (B and C) and open fracture as independent predictors of delay to surgery. Predictors for increased LOS were high velocity mechanism of injury at 4 days longer and patients who needed soft tissue reconstruction at 21 days longer. In terms of downtime from work, only work injury has been identified as an independent predictor of ML at 88.5 days longer.

Conclusion: Tibial pilon fractures leads to significant morbidities with profound negative impact on patients' lives in terms of multiple surgical interventions required, prolonged hospital stay, need for readmissions and prolonged downtime from work. These morbidities from patients' perspective should be emphasized to patients and employers to manage their expectations and potential limitations.

Keywords: Impact; Morbidity; Patient perspective; Pilon fracture; Prognostic factor; Sequela.

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References

    1. Zelle BA, Dang KH, Ornell SS (2019) High-energy tibial pilon fractures: an instructional review. Int Orthop 43(8):1939–1950 - DOI - PubMed
    1. Kottmeier SA, Madison RD, Divaris N (2018) Pilon fracture: preventing complications. J Am Acad Orthop Surg 26(18):640–651 - DOI - PubMed
    1. Sirkin M, Sanders R, DiPasquale T, Herscovici D Jr (1999) A staged protocol for soft tissue management in the treatment of complex pilon fractures. J Orthop Trauma 13(2):78–84 - DOI - PubMed
    1. Tang X, Liu L, Tu CQ, Li J, Li Q, Pei FX (2014) Comparison of early and delayed open reduction and internal fixation for treating closed tibial pilon fractures. Foot Ankle Int 35(7):657–664 - DOI - PubMed
    1. Legallois Y, Baudelle F, Lavignac P, Garcia M, Meynard P, Cadennes A, Ribes C, Fabre T (2021) Tibial pilon fractures treated with a periarticular external fixator: retrospective study of 47 cases. Orthop Traumatol Surg Res 13:103148

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