Staged treatment of high energy midfoot fracture dislocations.

Abstract:

BACKGROUND:Staged care with interval external fixation is a successful established treatment strategy for high energy periarticular fractures with often extensive soft tissue damage such as the tibial plateau and plafond. The aim of the current study was to determine whether staged care of high energy midfoot fracture/dislocation with interval external fixation prior to definitive open reconstruction in the polytraumatized patient was both safe and efficacious. METHODS:One hundred twenty-three patients were operated on for high energy midfoot fracture/dislocation during the 8-year study period. Eighteen polytrauma patients were selectively treated with a staged protocol. Radiographic assessment was utilized to determine if the fixator achieved gross skeletal alignment. Further, final alignment after definitive reconstruction and postoperative complications were analyzed. RESULTS:The fixator improved both length and alignment of all high energy midfoot fracture/dislocations. Loss of acceptable reduction while in the temporary frame occurred in only 1 case. Final alignment after definitive reconstruction was anatomic in all cases. No cases of wound-related complication and/or deep infection occurred. CONCLUSION:Delayed reconstruction of high energy midfoot fracture/dislocation using interval external fixation should be an accepted care paradigm in selected polytrauma patients. LEVEL OF EVIDENCE:Level III, retrospective comparative study.

journal_name

Foot Ankle Int

authors

Kadow TR,Siska PA,Evans AR,Sands SS,Tarkin IS

doi

10.1177/1071100714552077

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

1287-91

issue

12

eissn

1071-1007

issn

1944-7876

pii

1071100714552077

journal_volume

35

pub_type

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