Short term results of atraumatic surgical approach for management of tibial plafond pilon fractures using limited exposure, indirect reduction technique, minimal internal fixation, and Ilizarov fixator

Between November 1998 and October 2001, 19 cases of tibial pilon fractures were operated upon by indirect reduction technique combined with minimal internal fixation, bone grafting as necessary and Ilizarov fixator. All were high-energy injuries with Ruedi-Allgower type II in 10 [52.63%] and type III in the remaining 9 [47.36%]. Three [15.78%] fractures were open and four patients [21.05%] had associated injuries. Seventeen [89.47%] patients were males and 2 [10.52%] patients were females. Their age ranged from 25 to 75 years with the mean age 44 years. Approximately half of the injuries were seen in young labor men. All open fractures were sustained by men, except one female that had open fracture with vascular injury. The mean time from admission to surgery was 7 hours for approximately 50% of cases and 7 days for the remaining cases. All 19 ankles were evaluated for an average 20 months postoperative [minimum 10 months and maximum 35 months]. All fractures in this study united with an average time of healing 5.6 months [165 days]. The results were evaluated according to the functional grading method described by Helfet, et al., 1994. The overall results at final follow up was excellent in 10 [52.63%] cases, adequate in 6 [31.57%] and poor in 3 [15.78%]. Complications occurred in 3 [15.87%] cases and included one [5.26%] deep infection, 2 [10.52%] post-traumatic arthritis which were correlated to initial injury and the reduction of the fracture

Digital function following delayed flexor tendon repair in no - man's land

Between February 1999 and December 2000, 112 fingers in 97 patients with neglected cut both flexor tendons in zone-II of the hand were treated by delayed primary repair. There were 79 males and 33 females with ages ranged from 4 to 68 years with an average age of 21 years. Most of the injuries [65] occurred at work and home accidents due to the careless use of cutting tools in 38 fingers and due to personal behavior factors in the remaining 9 digits. Radiologically, all digits were free from any bone or joint abnormalities and clinically, 19 digits were presented with mild to moderate limitation of passive motion of IP joints. The mean period of lapsing between injury and repair was 10 days with a range of 14-35 days