ABSTRACT
Fourteen patients with 15 pilon fractures were reviewed retrospectively to analyze cases treated by open reduction and internal fixation through both anteromedial and lateral incisions. The protocol for this procedure involved objective soft-tissue evaluation, anteromedial wound closure, judicious use of primary skin grafting, and delayed primary or secondary closure for the lateral wound. Eleven fractures were treated according to the established principles of the Association for the Study on Internal Fixation (AO/ASIF). The type and incidence of wound complications were recorded. Most injuries reviewed were of the high-energy or Type III fracture as defined by Reudi and Allgower. There was only one patient with a wound complication. This technique minimized the potential for wound complication and disastrous disability.
Subject(s)
Fracture Fixation, Internal/methods , Leg/surgery , Muscles/surgery , Tibial Fractures/surgery , Adult , Female , Humans , Male , Middle Aged , Retrospective Studies , Skin Transplantation , Surgical Wound Infection , Treatment OutcomeABSTRACT
A 33-year-old woman with asymptomatic osteoporosis sustained a spontaneous middiaphyseal fracture of the femur as the initial sign of Cushing's disease. Subsequently, she incurred a fracture of the ipsilateral hip and both bones of the forearm. All four fractures failed to unite. There were no symptoms of involvement of the axial skeleton. Although axial osteopenia is the most common skeletal finding in hypercortisolism, fractures exclusively limited to the appendicular skeleton should not preclude detailed diagnostic investigations of hypercortisolism.
