Case Report
Endoscopic Guided Tibiotalocalcaneal Arthrodesis After Failed Osteosynthesis of Pilon Fractures
| Frederick Michels1*, Arne Burssens1, Guy Putzeys1, Jan Van Der Bauwhede1 and Stéphane Guillo2 | ||
| 1Orthopaedic Department, AZ Groeninge Kortrijk, Belgium | ||
| 2Sports Clinic Bordeaux Mérignac, Mérignac, France | ||
| Corresponding Author : | Dr. Frederick Michels Orthopaedic Department, AZ Groeninge Kortrijk Burg Vercruysselaan 5, 8500 Kortrijk, Belgium Tel: 0032 497 31 75 76 E-mail: frederick_michels@hotmail.com |
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| Received January 30, 2014; Accepted February 25, 2014; Published February 27, 2014 | ||
| Citation: Michels F, Burssens A, Putzeys G, Bauwhede JVD, Guillo S (2014) Endoscopic Guided Tibiotalocalcaneal Arthrodesis After Failed Osteosynthesis of Pilon Fractures. Clin Res Foot Ankle 2:135. doi:10.4172/2329-910X.1000135 | ||
| Copyright: © 2014 Michels F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | ||
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Abstract
Pilon fractures are difficult to treat because of the fracture pattern and are usually associated with significant soft tissue injury, which may result in a series of complications. Patients with diabetes and sensory neuropathy are at even greater risk of fixation failure, skin flap necrosis and deep infection. Treatment of complicated situations in patients is even more challenging and often results in an amputation. We describe a surgical treatment in two steps. First, we recommend an aggressive debridement to eradicate infection. After recovery of soft tissues, hindfoot fusion with a retrograde intramedullary nail helps to obtain a stable fixation. The removal of the cartilage can be performed endoscopically. This minimizes new soft tissue damage and favours wound healing. This treatment provides the patient with a pain-free plantigrade foot for ambulation.
