Incidence and Management Implications of Talus Osteochondral Lesions in Tibial Plafond (Pilon) Fractures Identified Via Nano-Arthroscopy at Time of External Fixation: A Pilot Study
University of Missouri-Columbia
Summary
Patients with pilon fractures have a high incidence of talar osteochondral lesions. In this study, patients will undergo ankle arthroscopy at the time of external fixation. The objective is to help determine the incidence of these lesions with pilon fractures and to see if these nano-arthroscopy results change the plan for definitive treatment.
Description
Previous studies have demonstrated a high incidence of talus osteochondral lesions (OCLs) associated with rotational ankle fractures, with rates reported as high as 45%. Consequently, an increasing number of surgeons have employed ankle arthroscopy at the time of fixation to evaluate and manage potential OCLs. To date, no studies have assessed the incidence of talus OCLs associated with high-energy tibial plafond (pilon) fractures. Ankle arthroscopy at the time of definitive fixation for pilon fractures is often contraindicated due to significant soft tissue swelling and the risk of wound com…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age ≥ 18 years (skeletally mature) Tibial plafond fractures with impaction of the articular surface requiring external fixation for temporization AO/Orthopaedic Trauma Association (OTA) Fracture classification 43-C type fractures (excluding posterior pilon or supination-adduction type ankle fractures) Closed injury Exclusion Criteria: * Prior ankle surgery * Pre-existing ankle arthritis * Unstable polytrauma patients precluding safe temporization * Concomitant talus or calcaneus fractures identifiable on plain radiographs * Pregnant * Prisoner * Unable to…
Interventions
- ProcedureDiagnostic Ankle Nano-Arthroscopy
Following placement of the external fixator, the Arthrex Nanoscope will be introduced into the tibiotalar joint to evaluate for osteochondral lesions
Location
- University of Missouri - ColumbiaColumbia, Missouri