CME OnDemand: 2022 AOFAS Annual Meeting-Comparison of Complications and Reoperation Rates of Minimally Invasive Circular Fixation vs Conventional ORIF for AO/ASIF C3 Pilon Fractures

Comparison of Complications and Reoperation Rates of Minimally Invasive Circular Fixation vs Conventional ORIF for AO/ASIF C3 Pilon Fractures

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This study compares the complications and reoperation rates of two treatment strategies, open reduction and internal fixation (ORIF) versus minimally invasive strategies (MIS) using percutaneous articular reduction and circular external fixation, in AO/ASIF C3 tibial pilon fractures. The researchers conducted a retrospective study on 30 patients in the ORIF group and 20 patients in the MIS group.<br /><br />The results showed that the MIS group had a higher union rate (95%) compared to the ORIF group (78%). However, the healing time was not significantly different between the two groups. Minor complications were more common in the MIS group, with superficial infection at the k-wire insertion site being the most common. Major complications occurred in 20% of the MIS group, while the ORIF group had a significantly higher rate (46%) of major complications, including nonunion, deep wound infection, and malunion. The ORIF group also required more surgeries, with a mean of 2.7 procedures compared to 1.5 procedures in the MIS group.<br /><br />Based on the findings, the researchers concluded that MIS treatment of C3 pilon fractures has a higher union rate and a lower rate of major complications compared to ORIF. They suggest that MIS should be considered as a valid strategy for treating these challenging injuries. They also recommend caution when using ORIF in patients with C3 fractures, especially when soft tissue is compromised.<br /><br />It is worth noting that this study focused exclusively on C3 fractures and found no significant difference in healing time between the two treatment strategies. The research was presented at the AOFAS Annual Meeting in September 2022.

Asset Subtitle

Gonzalo F. Bastias, MD, Sebastián S. Sepúlveda Godoy, Sergio S. Bruna, MD, Maximiliano Hube, MD, Juan P. Bergeret, MD, Natalio R. Cuchacovich Mikenberg, MD, Patricio A. Fuentes

Keywords

complications

reoperation rates

ORIF

MIS

union rate

healing time

minor complications

major complications

surgeries

C3 fractures