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Clinical application of arthroscopy-assisted minimally invasive therapy in Chinese elderly with type III Pilon fracture

Authors Liu P, Guo Y, Wen Y, Wang W

Received 23 April 2017

Accepted for publication 1 October 2017

Published 28 November 2017 Volume 2017:12 Pages 2033—2038

DOI https://doi.org/10.2147/CIA.S140272

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Wu


Peiming Liu, Yong Guo, Ying Wen, Wei Wang

The Eleventh Department of Orthopaedics, The Fifth Hospital of Harbin, Harbin, China

Objective: Pilon fracture is so complex that its therapy poses a great challenge to surgeons. Few studies have compared arthroscopy-assisted minimally invasive therapy and external fixation combined with limited internal fixation (EFLIF), and an optimal choice of surgical therapy remains unclear in patients with type III Pilon fracture. Moreover, to our knowledge, very few studies have specifically evaluated arthroscopy-assisted minimally invasive therapy in Chinese elderly with type III Pilon fracture. The current study was performed to observe the clinical application of arthroscopy-assisted minimally invasive therapy, compared with EFLIF, in Chinese elderly with type III Pilon fracture.
Methods: There were 230 Chinese elderly with type III Pilon fracture assigned to undergo EFLIF (group A, n=115) or arthroscopy-assisted minimally invasive therapy (group B, n=115), and followed up for 1 year after surgery.
Results: Age, sex, causes, sides and types of Pilon fractures were not different between the two groups (P>0.05 for all). Compared with EFLIF, arthroscopy-assisted minimally invasive therapy achieved a better reduction result, bone union and Mazur system (P<0.05 for all). Patient satisfaction, screw loosening and infection prevalence were not different between the two groups (P>0.05 for all). There was no skin necrosis in the two groups. Traumatic arthritis had a significantly lower prevalence in participants with arthroscopy-assisted minimally invasive therapy than EFLIF (P<0.05 for all).
Conclusion: Compared with EFLIF, arthroscopy-assisted minimally invasive therapy for type III Pilon fracture significantly improved reduction result, bone union and functional status, and decreased traumatic arthritis, demonstrating that arthroscopy-assisted minimally invasive therapy is an optimal choice for type III Pilon fracture in Chinese elderly.

Keywords: arthroscopy-assisted minimally invasive therapy, Chinese elderly, external fixation combined with limited internal fixation, type III Pilon fracture

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